- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $2,187.76 / $3,801.89
| Facility | | $158.49 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $158.49 / $501.19
| Professional | | $61.66 | $158.49 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $354.81 / $630.96
| Facility | | $147.91 | $354.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $165.96 / $467.74
| Professional | | $69.18 | $165.96 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $223.87 / $380.19
| Facility | | $58.88 | $223.87 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $147.91 / $380.19
| Professional | | $58.88 | $147.91 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $354.81 / $549.54
| Facility | | $147.91 | $354.81 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $162.18 / $380.19
| Professional | | $60.26 | $162.18 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $83.18 / $8,511.38
| Facility | | $50.12 | $83.18 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $144.54 / $234.42
| Professional | | $81.28 | $144.54 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $141.25 / $354.81
| Professional | | $50.12 | $141.25 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $354.81 / $630.96
| Facility | | $147.91 | $354.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $169.82 / $467.74
| Professional | | $69.18 | $169.82 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $223.87 / $302.00
| Professional | | $141.25 | $223.87 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $436.52 / $758.58
| Facility | | $120.23 | $436.52 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $162.18 / $346.74
| Professional | | $70.79 | $162.18 | $346.74 |