- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.09 / $683.35 / $821.04
| Facility | | $184.09 | $683.35 | $821.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.89 / $194.61 / $289.29
| Professional | | $174.89 | $194.61 | $289.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.32 / $300.75 / $823.42
| Facility | | $194.32 | $300.75 | $823.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.79 / $262.99 / $1,042.92
| Professional | | $157.79 | $262.99 | $1,042.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.22 / $608.05 / $1,063.05
| Facility | | $425.22 | $608.05 | $1,063.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.21 / $247.21 / $247.21
| Professional | | $247.21 | $247.21 | $247.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.01 / $188.03 / $598.29
| Facility | | $164.01 | $188.03 | $598.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.57 / $252.45 / $513.10
| Professional | | $139.57 | $252.45 | $513.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.99 / $525.98 / $6,679.00
| Facility | | $262.99 | $525.98 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.60 / $368.19 / $560.16
| Professional | | $290.60 | $368.19 | $560.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.99 / $262.99 / $586.47
| Professional | | $262.99 | $262.99 | $586.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.60 / $1,249.20 / $1,249.20
| Facility | | $457.60 | $1,249.20 | $1,249.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.79 / $157.79 / $1,309.69
| Professional | | $157.79 | $157.79 | $1,309.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.27 / $314.16 / $599.54
| Facility | | $223.27 | $314.16 | $599.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.79 / $157.79 / $505.20
| Professional | | $157.79 | $157.79 | $505.20 |