- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.63 / $501.54 / $926.76
| Facility | | $152.63 | $501.54 | $926.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.37 / $152.63 / $256.37
| Professional | | $143.37 | $152.63 | $256.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.86 / $662.90 / $1,035.79
| Facility | | $254.86 | $662.90 | $1,035.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.84 / $218.06 / $531.15
| Professional | | $130.84 | $218.06 | $531.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.91 / $81.06 / $141.72
| Facility | | $50.91 | $81.06 | $141.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.16 / $155.91 / $496.09
| Facility | | $143.16 | $155.91 | $496.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.11 / $265.56 / $407.10
| Professional | | $122.11 | $265.56 | $407.10 |
- 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
- $314.58 / $314.58 / $370.10
| Professional | | $314.58 | $314.58 | $370.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.06 / $287.83 / $623.65
| Professional | | $218.06 | $287.83 | $623.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $250.00 / $250.00
| Facility | | $250.00 | $250.00 | $250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.42 / $1,035.79 / $1,035.79
| Facility | | $379.42 | $1,035.79 | $1,035.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.22 / $130.84 / $381.61
| Professional | | $87.22 | $130.84 | $381.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.13 / $130.84 / $149.81
| Facility | | $98.13 | $130.84 | $149.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.22 / $130.84 / $327.08
| Professional | | $87.22 | $130.84 | $327.08 |