- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.52 / $1,133.79 / $1,686.73
| Facility | | $267.52 | $1,133.79 | $1,686.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.03 / $172.24 / $267.52
| Professional | | $99.03 | $172.24 | $267.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.22 / $873.48 / $1,736.49
| Facility | | $531.22 | $873.48 | $1,736.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.85 / $394.23 / $1,571.03
| Professional | | $213.85 | $394.23 | $1,571.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.10 / $397.37 / $587.77
| Professional | | $237.10 | $397.37 | $587.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.31 / $331.24 / $614.11
| Facility | | $199.31 | $331.24 | $614.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.31 / $312.51 / $561.77
| Professional | | $199.31 | $312.51 | $561.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $50.00 / $321.75
| Professional | | $45.00 | $50.00 | $321.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.26 / $226.42 / $238.34
| Facility | | $179.26 | $226.42 | $238.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.52 / $249.52 / $260.93
| Facility | | $249.52 | $249.52 | $260.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.83 / $388.82 / $511.77
| Professional | | $256.83 | $388.82 | $511.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.04 / $888.99 / $1,701.50
| Facility | | $649.04 | $888.99 | $1,701.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.01 / $355.18 / $500.55
| Professional | | $243.01 | $355.18 | $500.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.93 / $336.56 / $585.62
| Professional | | $157.93 | $336.56 | $585.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.34 / $275.48 / $546.97
| Professional | | $238.34 | $275.48 | $546.97 |