- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.84 / $297.08 / $635.63
| Facility | | $99.84 | $297.08 | $635.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.85 / $106.97 / $195.87
| Professional | | $94.85 | $106.97 | $195.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.39 / $163.11 / $446.57
| Facility | | $105.39 | $163.11 | $446.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $142.63 / $565.62
| Professional | | $85.58 | $142.63 | $565.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.53 / $329.66 / $576.33
| Facility | | $230.53 | $329.66 | $576.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.07 / $134.07 / $134.07
| Professional | | $134.07 | $134.07 | $134.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.95 / $101.98 / $324.49
| Facility | | $88.95 | $101.98 | $324.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.70 / $136.96 / $278.32
| Professional | | $75.70 | $136.96 | $278.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.84 / $205.84 / $242.16
| Professional | | $205.84 | $205.84 | $242.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $142.63 / $332.33
| Professional | | $142.63 | $142.63 | $332.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.52 / $177.40 / $277.08
| Facility | | $140.52 | $177.40 | $277.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.18 / $677.49 / $677.49
| Facility | | $248.18 | $677.49 | $677.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $85.58 / $710.30
| Professional | | $85.58 | $85.58 | $710.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.72 / $150.28 / $241.47
| Facility | | $117.72 | $150.28 | $241.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.36 / $170.21 / $248.46
| Professional | | $138.36 | $170.21 | $248.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $85.58 / $254.75
| Professional | | $85.58 | $85.58 | $254.75 |