- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.98 / $248.82 / $14,482.00
| Facility | | $71.98 | $248.82 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.39 / $178.75 / $356.16
| Professional | | $68.39 | $178.75 | $356.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.86 / $216.77 / $629.39
| Professional | | $80.86 | $216.77 | $629.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.28 / $636.03 / $845.34
| Facility | | $544.28 | $636.03 | $845.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $198.88 / $575.44
| Professional | | $81.28 | $198.88 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.39 / $145.27 / $319.45
| Facility | | $68.39 | $145.27 | $319.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.39 / $156.29 / $363.26
| Facility | | $68.39 | $156.29 | $363.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.24 / $506.27 / $1,237.14
| Professional | | $208.24 | $506.27 | $1,237.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.40 / $190.37 / $412.78
| Professional | | $112.40 | $190.37 | $412.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.39 / $145.72 / $361.66
| Facility | | $68.39 | $145.72 | $361.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.01 / $297.00 / $646.91
| Professional | | $151.01 | $297.00 | $646.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.30 / $363.26 / $618.95
| Facility | | $158.30 | $363.26 | $618.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.97 / $736.38 / $1,237.14
| Professional | | $132.97 | $736.38 | $1,237.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.87 / $393.09 / $1,022.77
| Professional | | $170.87 | $393.09 | $1,022.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.63 / $407.00 / $751.79
| Professional | | $204.63 | $407.00 | $751.79 |