- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $2,041.74
| Facility | | $245.47 | $245.47 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $281.84 / $776.25
| Professional | | $223.87 | $281.84 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $575.44 / $3,235.94
| Facility | | $501.19 | $575.44 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $416.87 / $575.44
| Professional | | $229.09 | $416.87 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $977.24
| Facility | | $323.59 | $323.59 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $467.74 / $467.74
| Professional | | $371.54 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $363.08 / $398.11
| Facility | | $323.59 | $363.08 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $416.87
| Professional | | $263.03 | $263.03 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $741.31
| Professional | | $489.78 | $489.78 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Professional | | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $575.44 / $3,235.94
| Facility | | $501.19 | $575.44 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $426.58 / $602.56
| Professional | | $229.09 | $426.58 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.41 / $323.59 / $691.83
| Facility | | $0.41 | $323.59 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $323.59 / $489.78
| Professional | | $218.78 | $323.59 | $489.78 |