- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.85 / $233.85 / $269.08
| Facility | | $233.85 | $233.85 | $269.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.43 / $272.88 / $431.39
| Professional | | $228.43 | $272.88 | $431.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.72 / $1,383.91 / $2,563.00
| Facility | | $417.72 | $1,383.91 | $2,563.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.91 / $397.59 / $522.66
| Professional | | $221.91 | $397.59 | $522.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.07 / $691.13 / $890.04
| Facility | | $568.07 | $691.13 | $890.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.93 / $558.29 / $762.52
| Professional | | $361.93 | $558.29 | $762.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.89 / $336.03 / $393.38
| Facility | | $321.89 | $336.03 | $393.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $635.63
| Professional | | $245.30 | $245.30 | $635.63 |
- 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
- $433.34 / $433.34 / $455.01
| Professional | | $433.34 | $433.34 | $455.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.14 / $271.14 / $271.14
| Facility | | $271.14 | $271.14 | $271.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.60 / $304.60 / $304.60
| Professional | | $304.60 | $304.60 | $304.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.23 / $2,563.00 / $2,563.00
| Facility | | $1,113.23 | $2,563.00 | $2,563.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.66 / $267.01 / $522.66
| Professional | | $203.66 | $267.01 | $522.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.13 / $376.60 / $455.01
| Professional | | $207.13 | $376.60 | $455.01 |