- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.56 / $202.74 / $273.64
| Facility | | $58.56 | $202.74 | $273.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.53 / $254.93 / $559.00
| Professional | | $195.53 | $254.93 | $559.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.72 / $818.35 / $2,733.00
| Facility | | $409.72 | $818.35 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.98 / $342.13 / $863.99
| Professional | | $207.98 | $342.13 | $863.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.58 / $453.58 / $601.78
| Professional | | $276.58 | $453.58 | $601.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.85 / $346.87 / $475.90
| Facility | | $199.85 | $346.87 | $475.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.88 / $348.41 / $731.62
| Professional | | $231.88 | $348.41 | $731.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.97 / $504.34 / $6,679.00
| Facility | | $224.97 | $504.34 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.97 / $247.47 / $377.25
| Professional | | $134.97 | $247.47 | $377.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.52 / $480.55 / $671.27
| Professional | | $269.52 | $480.55 | $671.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.07 / $196.07 / $196.07
| Facility | | $196.07 | $196.07 | $196.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.00 / $512.00 / $803.07
| Professional | | $300.00 | $512.00 | $803.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.00 / $1,194.33 / $3,445.00
| Facility | | $502.00 | $1,194.33 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.95 / $342.13 / $1,509.85
| Professional | | $232.95 | $342.13 | $1,509.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.81 / $308.76 / $638.77
| Professional | | $227.81 | $308.76 | $638.77 |