- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.40 / $182.84 / $1,940.12
| Facility | | $154.40 | $182.84 | $1,940.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.40 / $244.76 / $364.04
| Professional | | $154.40 | $244.76 | $364.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.21 / $179.37 / $576.48
| Professional | | $137.21 | $179.37 | $576.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.54 / $350.04 / $350.04
| Facility | | $325.54 | $350.04 | $350.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.04 / $350.04 / $350.04
| Professional | | $350.04 | $350.04 | $350.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.38 / $373.38 / $373.38
| Facility | | $373.38 | $373.38 | $373.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.37 / $317.37 / $373.38
| Professional | | $317.37 | $317.37 | $373.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $420.15 / $945.34
| Facility | | $319.00 | $420.15 | $945.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.89 / $352.93 / $765.51
| Professional | | $247.89 | $352.93 | $765.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.59 / $268.38 / $350.04
| Professional | | $252.59 | $268.38 | $350.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.38 / $373.38 / $555.00
| Facility | | $373.38 | $373.38 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.67 / $317.37 / $651.23
| Professional | | $259.67 | $317.37 | $651.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.74 / $252.09 / $378.14
| Professional | | $139.74 | $252.09 | $378.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.59 / $252.59 / $262.49
| Facility | | $252.59 | $252.59 | $262.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.59 / $252.59 / $268.38
| Professional | | $252.59 | $252.59 | $268.38 |