- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.77 / $295.55 / $434.68
| Facility | | $142.77 | $295.55 | $434.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.62 / $148.38 / $485.80
| Professional | | $142.62 | $148.38 | $485.80 |
- 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
- $132.97 / $168.96 / $710.30
| Professional | | $132.97 | $168.96 | $710.30 |
- 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
- $141.19 / $142.63 / $142.63
| Professional | | $141.19 | $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
- $142.63 / $174.85 / $269.47
| Facility | | $142.63 | $174.85 | $269.47 |
- 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
- $117.26 / $168.96 / $710.30
| Professional | | $117.26 | $168.96 | $710.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.63 / $193.21 / $334.44
| Facility | | $142.63 | $193.21 | $334.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $164.02 / $213.95
| Professional | | $142.63 | $164.02 | $213.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.10 / $142.63 / $344.70
| Professional | | $114.10 | $142.63 | $344.70 |