- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $724.44 / $1,412.54
| Facility | | $281.84 | $724.44 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $151.36 / $1,023.29
| Professional | | $117.49 | $151.36 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $416.87 / $891.25
| Facility | | $83.18 | $416.87 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $204.17 / $371.54
| Professional | | $70.79 | $204.17 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $416.87 / $1,698.24
| Facility | | $69.18 | $416.87 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $147.91 / $363.08
| Professional | | $104.71 | $147.91 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $316.23 / $630.96
| Facility | | $125.89 | $316.23 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $190.55 / $269.15
| Professional | | $91.20 | $190.55 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $177.83 / $281.84
| Professional | | $100.00 | $177.83 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $177.83 / $398.11
| Professional | | $141.25 | $177.83 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $177.83
| Professional | | $89.13 | $89.13 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $194.98 / $467.74
| Facility | | $89.13 | $194.98 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $154.88 / $354.81
| Professional | | $91.20 | $154.88 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Professional | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $97.72 / $177.83
| Facility | | $79.43 | $97.72 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $81.28 / $316.23
| Professional | | $74.13 | $81.28 | $316.23 |