- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $398.11 / $954.99
| Facility | | $141.25 | $398.11 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $190.55 / $588.84
| Professional | | $128.82 | $190.55 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $501.19 / $1,445.44
| Facility | | $173.78 | $501.19 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $660.69
| Professional | | $181.97 | $302.00 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $194.98 / $263.03
| Facility | | $165.96 | $194.98 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Professional | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $213.80 / $323.59
| Facility | | $89.13 | $213.80 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $309.03 / $707.95
| Professional | | $204.17 | $309.03 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $389.05 / $7,079.46
| Facility | | $218.78 | $389.05 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $218.78 / $389.05
| Professional | | $120.23 | $218.78 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $275.42 / $602.56
| Professional | | $234.42 | $275.42 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $338.84 / $524.81
| Facility | | $144.54 | $338.84 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $354.81 / $354.81
| Professional | | $346.74 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $501.19 / $1,445.44
| Facility | | $173.78 | $501.19 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $660.69
| Professional | | $181.97 | $302.00 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $223.87 / $223.87
| Facility | | $165.96 | $223.87 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $281.84 / $645.65
| Professional | | $190.55 | $281.84 | $645.65 |