- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $295.12 / $1,995.26
| Facility | | $89.13 | $295.12 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $181.97 / $537.03
| Professional | | $79.43 | $181.97 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $281.84 / $741.31
| Facility | | $177.83 | $281.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | 52 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $181.97 / $1,862.09
| Professional | | $81.28 | $181.97 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $263.03 / $616.60
| Facility | | $87.10 | $263.03 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $229.09 / $263.03 / $346.74
| Facility | 52 | $229.09 | $263.03 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $190.55 / $426.58
| Professional | | $87.10 | $190.55 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $724.44 / $1,318.26
| Facility | | $199.53 | $724.44 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $177.83 / $398.11
| Professional | | $89.13 | $177.83 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $128.82 / $7,079.46
| Facility | | $67.61 | $128.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $177.83 / $346.74
| Professional | | $93.33 | $177.83 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $181.97 / $416.87
| Professional | | $79.43 | $181.97 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,348.96 / $2,089.30
| Facility | | $407.38 | $1,348.96 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $616.60
| Professional | | $524.81 | $524.81 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $281.84 / $741.31
| Facility | | $177.83 | $281.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | 52 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $181.97 / $1,862.09
| Professional | | $81.28 | $181.97 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $724.44 / $1,230.27
| Facility | | $416.87 | $724.44 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $181.97 / $426.58
| Professional | | $81.28 | $181.97 | $426.58 |