- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.30 / $180.30 / $242.59
| Facility | | $180.30 | $180.30 | $242.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.36 / $180.30 / $232.34
| Professional | | $105.36 | $180.30 | $232.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.66 / $834.84 / $1,960.04
| Facility | | $293.66 | $834.84 | $1,960.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.18 / $279.68 / $402.97
| Professional | | $151.18 | $279.68 | $402.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.97 / $532.84 / $686.20
| Facility | | $437.97 | $532.84 | $686.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.85 / $402.61 / $518.58
| Professional | | $282.85 | $402.61 | $518.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.42 / $238.68 / $289.29
| Facility | | $216.42 | $238.68 | $289.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.99 / $216.42 / $345.05
| Professional | | $157.99 | $216.42 | $345.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.10 / $334.10 / $350.80
| Professional | | $334.10 | $334.10 | $350.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.62 / $196.62 / $196.62
| Professional | | $196.62 | $196.62 | $196.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.80 / $1,960.04 / $1,960.04
| Facility | | $684.80 | $1,960.04 | $1,960.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.24 / $205.86 / $402.97
| Professional | | $137.24 | $205.86 | $402.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.25 / $153.02 / $164.30
| Facility | | $0.25 | $153.02 | $164.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.24 / $205.86 / $334.10
| Professional | | $137.24 | $205.86 | $334.10 |