- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $8,511.38 / $8,511.38
| Facility | | $117.49 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $128.82 / $302.00
| Professional | | $107.15 | $128.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $302.00 / $446.68
| Professional | | $223.87 | $302.00 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $977.24 / $1,548.82
| Facility | | $478.63 | $977.24 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $407.38 / $446.68
| Professional | | $346.74 | $407.38 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $181.97 / $354.81
| Facility | | $117.49 | $181.97 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $851.14 / $1,122.02
| Professional | | $323.59 | $851.14 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $257.04 / $1,230.27
| Facility | | $125.89 | $257.04 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $251.19 / $426.58
| Professional | | $141.25 | $251.19 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $64.57 / $346.74
| Professional | | $50.12 | $64.57 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $549.54 / $758.58
| Professional | | $295.12 | $549.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $575.44 / $1,513.56
| Facility | | $478.63 | $575.44 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $478.63 / $1,513.56
| Professional | | $407.38 | $478.63 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $234.42 / $389.05
| Facility | | $186.21 | $234.42 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $234.42 / $389.05
| Professional | | $125.89 | $234.42 | $389.05 |