- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.86 / $247.44 / $581.67
| Facility | | $102.86 | $247.44 | $581.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.53 / $76.75 / $145.61
| Professional | | $53.53 | $76.75 | $145.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $119.88 / $266.45
| Facility | | $77.62 | $119.88 | $266.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.29 / $85.10 / $699.71
| Professional | | $48.29 | $85.10 | $699.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.27 / $239.20 / $418.18
| Facility | | $167.27 | $239.20 | $418.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.88 / $79.98 / $79.98
| Professional | | $71.88 | $79.98 | $79.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.76 / $145.46 / $328.48
| Facility | | $80.76 | $145.46 | $328.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.21 / $89.82 / $229.96
| Professional | | $51.21 | $89.82 | $229.96 |
- 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
- $122.75 / $122.75 / $144.41
| Professional | | $122.75 | $122.75 | $144.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.10 / $85.10 / $263.55
| Professional | | $85.10 | $85.10 | $263.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.00 / $127.78 / $268.06
| Facility | | $90.00 | $127.78 | $268.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.07 / $405.72 / $405.72
| Facility | | $148.07 | $405.72 | $405.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.11 / $65.73 / $699.71
| Professional | | $47.11 | $65.73 | $699.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.95 / $75.05 / $120.90
| Facility | | $57.95 | $75.05 | $120.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.52 / $82.56 / $127.65
| Professional | | $69.52 | $82.56 | $127.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.11 / $51.06 / $162.21
| Professional | | $47.11 | $51.06 | $162.21 |