- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.44 / $437.34 / $824.95
| Facility | | $158.44 | $437.34 | $824.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.66 / $173.20 / $332.30
| Professional | | $140.66 | $173.20 | $332.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.72 / $234.33 / $581.76
| Facility | | $151.72 | $234.33 | $581.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.72 / $227.89 / $1,367.63
| Professional | | $151.72 | $227.89 | $1,367.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.20 / $450.58 / $816.28
| Facility | | $293.20 | $450.58 | $816.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.24 / $163.24 / $212.76
| Professional | | $163.24 | $163.24 | $212.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.85 / $284.52 / $642.14
| Facility | | $157.85 | $284.52 | $642.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.49 / $187.19 / $452.88
| Professional | | $104.49 | $187.19 | $452.88 |
- 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
- $250.65 / $250.65 / $294.88
| Professional | | $250.65 | $250.65 | $294.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.66 / $342.80 / $564.40
| Professional | | $173.66 | $342.80 | $564.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.33 / $1,070.33 / $1,070.33
| Facility | | $1,070.33 | $1,070.33 | $1,070.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.17 / $824.89 / $824.89
| Facility | | $302.17 | $824.89 | $824.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.43 / $232.38 / $1,367.63
| Professional | | $139.43 | $232.38 | $1,367.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.43 / $181.30 / $396.50
| Professional | | $139.43 | $181.30 | $396.50 |