- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.91 / $285.26 / $536.13
| Facility | | $146.91 | $285.26 | $536.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.62 / $142.63 / $407.62
| Professional | | $142.62 | $142.63 | $407.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.03 / $416.05 / $521.13
| Facility | | $189.03 | $416.05 | $521.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $142.63 / $565.62
| Professional | | $85.58 | $142.63 | $565.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.63 / $215.80 / $382.53
| Facility | | $142.63 | $215.80 | $382.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $142.63 / $142.63
| Professional | | $142.63 | $142.63 | $142.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.64 / $98.32 / $229.32
| Facility | | $93.64 | $98.32 | $229.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.62 / $142.63 / $249.76
| Professional | | $81.62 | $142.63 | $249.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.63 / $285.26 / $6,679.00
| Facility | | $142.63 | $285.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.61 / $199.68 / $303.80
| Professional | | $157.61 | $199.68 | $303.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $142.63 / $441.74
| Professional | | $142.63 | $142.63 | $441.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.91 / $169.13 / $303.33
| Facility | | $128.91 | $169.13 | $303.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.18 / $677.49 / $677.49
| Facility | | $248.18 | $677.49 | $677.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $132.97 / $710.30
| Professional | | $85.58 | $132.97 | $710.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.63 / $193.26 / $337.48
| Facility | | $142.63 | $193.26 | $337.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.58 / $114.10 / $360.48
| Professional | | $85.58 | $114.10 | $360.48 |