- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.73 / $289.33 / $483.45
| Professional | | $186.73 | $289.33 | $483.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.63 / $36.15 / $890.16
| Facility | | $32.63 | $36.15 | $890.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.47 / $403.64 / $563.89
| Professional | | $361.47 | $403.64 | $563.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.03 / $784.03 / $784.03
| Facility | | $784.03 | $784.03 | $784.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $296.70 / $526.08
| Professional | | $100.00 | $296.70 | $526.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.55 / $353.55 / $526.08
| Facility | | $353.55 | $353.55 | $526.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.52 / $353.55 / $645.00
| Professional | | $300.52 | $353.55 | $645.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.98 / $473.98 / $568.78
| Professional | | $473.98 | $473.98 | $568.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.03 / $436.37 / $801.00
| Professional | | $374.03 | $436.37 | $801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.61 / $2,537.59 / $2,537.59
| Facility | | $695.61 | $2,537.59 | $2,537.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.30 / $359.99 / $662.23
| Facility | | $181.30 | $359.99 | $662.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.52 / $353.55 / $422.81
| Professional | | $300.52 | $353.55 | $422.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,036.18 / $1,036.18 / $1,036.18
| Professional | | $1,036.18 | $1,036.18 | $1,036.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.35 / $417.35 / $473.98
| Professional | | $417.35 | $417.35 | $473.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.37 / $259.64 / $406.04
| Professional | | $216.37 | $259.64 | $406.04 |