- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.08 / $733.05 / $1,109.94
| Facility | | $109.08 | $733.05 | $1,109.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.03 / $109.08 / $237.28
| Professional | | $104.03 | $109.08 | $237.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.72 / $380.77 / $1,547.55
| Facility | | $240.72 | $380.77 | $1,547.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.74 / $287.31 / $793.58
| Professional | | $97.74 | $287.31 | $793.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.36 / $714.62 / $1,294.59
| Facility | | $220.36 | $714.62 | $1,294.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.47 / $306.25 / $322.54
| Professional | | $146.47 | $306.25 | $322.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.91 / $254.12 / $523.33
| Facility | | $144.91 | $254.12 | $523.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.69 / $210.62 / $496.11
| Professional | | $88.69 | $210.62 | $496.11 |
- 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
- $470.02 / $470.02 / $552.96
| Professional | | $470.02 | $470.02 | $552.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.80 / $416.32 / $1,049.08
| Professional | | $325.80 | $416.32 | $1,049.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.45 / $655.17 / $1,188.74
| Facility | | $378.45 | $655.17 | $1,188.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.89 / $1,547.55 / $1,547.55
| Facility | | $566.89 | $1,547.55 | $1,547.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.44 / $190.26 / $272.98
| Professional | | $94.44 | $190.26 | $272.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.44 / $195.48 / $325.80
| Professional | | $94.44 | $195.48 | $325.80 |