- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.77 / $450.53 / $995.15
| Facility | | $145.77 | $450.53 | $995.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.37 / $171.20 / $283.20
| Professional | | $78.37 | $171.20 | $283.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.84 / $301.29 / $800.80
| Facility | | $234.84 | $301.29 | $800.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.13 / $257.45 / $1,870.44
| Professional | | $108.13 | $257.45 | $1,870.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.18 / $680.05 / $1,263.09
| Facility | | $159.18 | $680.05 | $1,263.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.24 / $242.00 / $242.00
| Professional | | $105.24 | $242.00 | $242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.60 / $440.06 / $993.92
| Facility | | $206.60 | $440.06 | $993.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.53 / $271.64 / $695.22
| Professional | | $154.53 | $271.64 | $695.22 |
- 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
- $371.52 / $371.52 / $437.09
| Professional | | $371.52 | $371.52 | $437.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.45 / $257.45 / $797.30
| Professional | | $257.45 | $257.45 | $797.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.63 / $303.13 / $401.39
| Facility | | $107.63 | $303.13 | $401.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.96 / $1,228.92 / $1,228.92
| Facility | | $447.96 | $1,228.92 | $1,228.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.97 / $154.47 / $1,870.44
| Professional | | $68.97 | $154.47 | $1,870.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.97 / $154.47 / $503.57
| Professional | | $68.97 | $154.47 | $503.57 |