- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $325.02 / $961.34
| Facility | | $141.25 | $325.02 | $961.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.23 / $173.42 / $374.88
| Professional | | $119.23 | $173.42 | $374.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.36 / $501.76 / $941.10
| Facility | | $172.36 | $501.76 | $941.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.98 / $303.23 / $636.78
| Professional | | $180.98 | $303.23 | $636.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.76 / $191.88 / $247.63
| Facility | | $160.76 | $191.88 | $247.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.27 / $271.27 / $271.27
| Professional | | $271.27 | $271.27 | $271.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.00 / $212.00 / $320.00
| Facility | | $90.00 | $212.00 | $320.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.24 / $351.43 / $702.95
| Professional | | $203.24 | $351.43 | $702.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.83 / $346.82 / $6,679.00
| Facility | | $230.83 | $346.82 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.44 / $215.83 / $369.98
| Professional | | $132.44 | $215.83 | $369.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.58 / $461.25 / $704.91
| Professional | | $240.58 | $461.25 | $704.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.79 / $262.64 / $1,004.70
| Facility | | $130.79 | $262.64 | $1,004.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.54 / $352.54 / $352.54
| Professional | | $352.54 | $352.54 | $352.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.00 / $522.82 / $1,170.26
| Facility | | $110.00 | $522.82 | $1,170.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.49 / $300.57 / $1,433.30
| Professional | | $198.49 | $300.57 | $1,433.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.31 / $172.36 / $299.02
| Facility | | $144.31 | $172.36 | $299.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.98 / $276.11 / $654.47
| Professional | | $188.98 | $276.11 | $654.47 |