- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.43 / $615.37 / $1,238.79
| Facility | | $109.43 | $615.37 | $1,238.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.43 / $192.50 / $299.45
| Professional | | $109.43 | $192.50 | $299.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.68 / $300.68 / $667.70
| Facility | | $194.68 | $300.68 | $667.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.74 / $218.06 / $864.75
| Professional | | $94.74 | $218.06 | $864.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.74 / $598.79 / $1,046.84
| Facility | | $418.74 | $598.79 | $1,046.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.27 / $425.21 / $823.97
| Facility | | $171.27 | $425.21 | $823.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.13 / $230.02 / $576.23
| Professional | | $131.13 | $230.02 | $576.23 |
- 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 / $218.06 / $675.31
| Professional | | $218.06 | $218.06 | $675.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $989.74 / $989.74 / $989.74
| Facility | | $989.74 | $989.74 | $989.74 |
- 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
- $94.74 / $130.84 / $1,126.45
| Professional | | $94.74 | $130.84 | $1,126.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.78 / $192.30 / $244.23
| Facility | | $171.78 | $192.30 | $244.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.74 / $130.84 / $401.92
| Professional | | $94.74 | $130.84 | $401.92 |