- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.25 / $521.36 / $615.21
| Facility | | $229.25 | $521.36 | $615.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.73 / $108.63 / $158.99
| Professional | | $87.73 | $108.63 | $158.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.02 / $155.02 / $155.02
| Professional | | $155.02 | $155.02 | $155.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.06 / $238.98 / $494.40
| Facility | | $133.06 | $238.98 | $494.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957.93 / $957.93 / $957.93
| Professional | | $957.93 | $957.93 | $957.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.68 / $268.30 / $490.89
| Professional | | $208.68 | $268.30 | $490.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.05 / $615.21 / $615.21
| Facility | | $405.05 | $615.21 | $615.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.63 / $229.25 / $615.21
| Professional | | $108.63 | $229.25 | $615.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.65 / $250.96 / $494.40
| Facility | | $170.65 | $250.96 | $494.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957.93 / $957.93 / $957.93
| Professional | | $957.93 | $957.93 | $957.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.96 / $148.96 / $182.07
| Facility | | $148.96 | $148.96 | $182.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.96 / $148.96 / $182.07
| Professional | | $148.96 | $148.96 | $182.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.56 / $89.38 / $299.13
| Professional | | $62.56 | $89.38 | $299.13 |