- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $257.04 / $436.52
| Facility | | $114.82 | $257.04 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $263.03 / $295.12
| Professional | | $218.78 | $263.03 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Professional | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Professional | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $288.40 / $50,118.72
| Facility | | $275.42 | $288.40 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $1,445.44
| Professional | | $275.42 | $275.42 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $141.25 / $323.59
| Facility | | $54.95 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $54.95 / $54.95
| Professional | | $46.77 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $281.84 / $295.12
| Facility | | $275.42 | $281.84 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $281.84
| Professional | | $275.42 | $275.42 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $275.42 / $1,949.84
| Facility | | $77.62 | $275.42 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Professional | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $407.38
| Professional | | $269.15 | $269.15 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $281.84 / $295.12
| Facility | | $54.95 | $281.84 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $275.42 / $281.84
| Professional | | $151.36 | $275.42 | $281.84 |