- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.00 / $41.00 / $1,146.00
| Facility | | $38.00 | $41.00 | $1,146.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $45.00 / $960.48
| Professional | | $30.00 | $45.00 | $960.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.02 / $343.80 / $572.16
| Professional | | $250.02 | $343.80 | $572.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $274.86 / $413.47
| Professional | | $100.00 | $274.86 | $413.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.50 / $350.00 / $523.65
| Professional | | $237.50 | $350.00 | $523.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.34 / $136.56 / $320.16
| Professional | | $77.34 | $136.56 | $320.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.86 / $300.00 / $516.00
| Professional | | $184.86 | $300.00 | $516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.00 / $82.00 / $82.00
| Facility | | $82.00 | $82.00 | $82.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,351.68 / $1,351.68 / $2,880.00
| Professional | | $1,351.68 | $1,351.68 | $2,880.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.15 / $350.00 / $400.00
| Professional | | $92.15 | $350.00 | $400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.40 / $3,375.00 / $4,100.00
| Facility | | $488.40 | $3,375.00 | $4,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.00 / $360.00 / $499.50
| Professional | | $250.00 | $360.00 | $499.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.00 / $485.00 / $485.00
| Professional | | $485.00 | $485.00 | $485.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $24.84 / $154.41
| Professional | | $18.05 | $24.84 | $154.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.00 / $51.00 / $85.16
| Professional | | $38.00 | $51.00 | $85.16 |