- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $2,238.72 / $3,801.89
| Facility | | $173.78 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $169.82 / $467.74
| Professional | | $64.57 | $169.82 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $354.81 / $645.65
| Facility | | $169.82 | $354.81 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $186.21 / $501.19
| Professional | | $75.86 | $186.21 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $239.88 / $380.19
| Facility | | $67.61 | $239.88 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $158.49 / $407.38
| Professional | | $67.61 | $158.49 | $407.38 |
- 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
- $67.61 / $177.83 / $407.38
| Professional | | $67.61 | $177.83 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $83.18 / $8,511.38
| Facility | | $56.23 | $83.18 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $154.88 / $251.19
| Professional | | $87.10 | $154.88 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $151.36 / $380.19
| Professional | | $56.23 | $151.36 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $354.81 / $645.65
| Facility | | $169.82 | $354.81 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $190.55 / $512.86
| Professional | | $75.86 | $190.55 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $436.52 / $758.58
| Facility | | $125.89 | $436.52 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $169.82 / $371.54
| Professional | | $74.13 | $169.82 | $371.54 |