- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.81 / $225.96 / $670.46
| Facility | | $96.81 | $225.96 | $670.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.96 / $251.36 / $383.60
| Professional | | $225.96 | $251.36 | $383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.92 / $941.10 / $2,758.85
| Facility | | $264.92 | $941.10 | $2,758.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.02 / $344.67 / $505.04
| Professional | | $202.02 | $344.67 | $505.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.91 / $667.81 / $860.01
| Facility | | $548.91 | $667.81 | $860.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.00 / $298.00 / $398.68
| Professional | | $298.00 | $298.00 | $398.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.31 / $299.14 / $362.56
| Facility | | $293.31 | $299.14 | $362.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.12 / $214.12 / $644.25
| Professional | | $214.12 | $214.12 | $644.25 |
- 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
- $418.72 / $418.72 / $439.66
| Professional | | $418.72 | $418.72 | $439.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.47 / $295.47 / $295.47
| Facility | | $295.47 | $295.47 | $295.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.44 / $295.47 / $295.47
| Professional | | $276.44 | $295.47 | $295.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.03 / $2,758.85 / $2,758.85
| Facility | | $1,128.03 | $2,758.85 | $2,758.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.10 / $258.01 / $505.04
| Professional | | $181.10 | $258.01 | $505.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.80 / $580.80 / $580.80
| Facility | | $580.80 | $580.80 | $580.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.42 / $258.50 / $450.14
| Professional | | $196.42 | $258.50 | $450.14 |