- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.97 / $460.85 / $1,052.53
| Facility | | $164.97 | $460.85 | $1,052.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.27 / $180.34 / $346.00
| Professional | | $140.27 | $180.34 | $346.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.97 / $243.98 / $580.12
| Facility | | $157.97 | $243.98 | $580.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.18 / $227.23 / $1,423.97
| Professional | | $145.18 | $227.23 | $1,423.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.04 / $468.77 / $849.23
| Facility | | $305.04 | $468.77 | $849.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.78 / $162.78 / $221.53
| Professional | | $162.78 | $162.78 | $221.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.35 / $296.24 / $668.59
| Facility | | $164.35 | $296.24 | $668.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.08 / $191.46 / $467.94
| Professional | | $104.08 | $191.46 | $467.94 |
- 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
- $249.71 / $249.71 / $293.77
| Professional | | $249.71 | $249.71 | $293.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.17 / $341.84 / $563.10
| Professional | | $173.17 | $341.84 | $563.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.24 / $254.24 / $254.24
| Facility | | $254.24 | $254.24 | $254.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.32 / $826.74 / $826.74
| Facility | | $301.32 | $826.74 | $826.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.90 / $241.96 / $1,423.97
| Professional | | $103.90 | $241.96 | $1,423.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.90 / $173.17 / $435.05
| Professional | | $103.90 | $173.17 | $435.05 |