- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.97 / $206.81 / $416.16
| Professional | | $144.97 | $206.81 | $416.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.67 / $24.01 / $588.25
| Facility | | $21.67 | $24.01 | $588.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.12 / $334.08 / $407.31
| Professional | | $240.12 | $334.08 | $407.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.36 / $560.36 / $560.36
| Facility | | $560.36 | $560.36 | $560.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $200.90 / $376.01
| Professional | | $100.00 | $200.90 | $376.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.17 / $243.17 / $376.01
| Facility | | $243.17 | $243.17 | $376.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.69 / $243.17 / $436.13
| Professional | | $206.69 | $243.17 | $436.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.61 / $356.61 / $427.93
| Professional | | $356.61 | $356.61 | $427.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.88 / $306.70 / $591.49
| Professional | | $262.88 | $306.70 | $591.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.18 / $1,744.00 / $1,744.00
| Facility | | $470.18 | $1,744.00 | $1,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.34 / $258.83 / $473.32
| Facility | | $150.34 | $258.83 | $473.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.69 / $243.17 / $318.60
| Professional | | $206.69 | $243.17 | $318.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $701.58 / $701.58 / $701.58
| Professional | | $701.58 | $701.58 | $701.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.80 / $275.80 / $356.61
| Professional | | $275.80 | $275.80 | $356.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.40 / $193.54 / $317.72
| Professional | | $180.40 | $193.54 | $317.72 |