- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.81 / $312.00 / $584.00
| Facility | | $33.81 | $312.00 | $584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $43.26 / $462.88
| Professional | | $30.00 | $43.26 | $462.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.88 / $400.00 / $630.00
| Professional | | $167.88 | $400.00 | $630.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.00 / $297.00 / $458.46
| Professional | | $174.00 | $297.00 | $458.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $300.00 / $300.00
| Facility | | $300.00 | $300.00 | $300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.88 / $320.00 / $485.12
| Professional | | $85.88 | $320.00 | $485.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.40 / $210.00 / $287.55
| Professional | | $50.40 | $210.00 | $287.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $74,999.25
| Facility | | $555.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.00 / $300.00 / $468.00
| Professional | | $171.00 | $300.00 | $468.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $75.00 / $122.00
| Professional | | $50.00 | $75.00 | $122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.00 / $132.00 / $132.00
| Facility | | $132.00 | $132.00 | $132.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.37 / $213.00 / $318.14
| Professional | | $59.37 | $213.00 | $318.14 |