- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.76 / $116.93 / $245.85
| Facility | | $74.76 | $116.93 | $245.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.00 / $140.32 / $300.00
| Professional | | $110.00 | $140.32 | $300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.88 / $762.36 / $1,281.52
| Facility | | $208.88 | $762.36 | $1,281.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.95 / $198.80 / $261.35
| Professional | | $110.95 | $198.80 | $261.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.06 / $345.59 / $445.05
| Facility | | $284.06 | $345.59 | $445.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.71 / $157.71 / $180.98
| Professional | | $157.71 | $157.71 | $180.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.00 / $135.00 / $196.69
| Facility | | $135.00 | $135.00 | $196.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.55 / $135.00 / $282.16
| Professional | | $98.55 | $135.00 | $282.16 |
- 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
- $216.67 / $216.67 / $227.50
| Professional | | $216.67 | $216.67 | $227.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.11 / $121.11 / $121.11
| Facility | | $121.11 | $121.11 | $121.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.72 / $161.44 / $161.44
| Professional | | $143.72 | $161.44 | $161.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.61 / $1,281.52 / $1,281.52
| Facility | | $556.61 | $1,281.52 | $1,281.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.83 / $133.51 / $261.35
| Professional | | $101.83 | $133.51 | $261.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.23 / $193.80 / $243.06
| Professional | | $116.23 | $193.80 | $243.06 |