- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.58 / $190.89 / $207.29
| Facility | | $165.58 | $190.89 | $207.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.65 / $154.18 / $190.89
| Professional | | $133.65 | $154.18 | $190.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.86 / $315.45 / $875.25
| Facility | | $227.86 | $315.45 | $875.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.70 / $410.50 / $1,436.33
| Professional | | $231.70 | $410.50 | $1,436.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.67 / $188.67 / $188.67
| Professional | | $188.67 | $188.67 | $188.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.12 / $202.43 / $381.83
| Facility | | $141.12 | $202.43 | $381.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.12 / $196.56 / $346.00
| Professional | | $141.12 | $196.56 | $346.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.32 / $298.11 / $520.78
| Professional | | $55.32 | $298.11 | $520.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.86 / $345.95 / $421.43
| Facility | | $252.86 | $345.95 | $421.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.86 / $227.86 / $287.45
| Facility | | $227.86 | $227.86 | $287.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.70 / $372.22 / $494.65
| Professional | | $231.70 | $372.22 | $494.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.39 / $314.50 / $475.77
| Professional | | $232.39 | $314.50 | $475.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.08 / $205.08 / $205.08
| Facility | | $205.08 | $205.08 | $205.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.32 / $277.24 / $476.89
| Professional | | $210.32 | $277.24 | $476.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.03 / $175.03 / $207.29
| Professional | | $175.03 | $175.03 | $207.29 |