- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.52 / $922.12 / $1,350.71
| Facility | | $274.52 | $922.12 | $1,350.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.51 / $261.60 / $274.52
| Professional | | $235.51 | $261.60 | $274.52 |
- 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
- $251.91 / $251.91 / $251.91
| Professional | | $251.91 | $251.91 | $251.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.27 / $419.84 / $944.64
| Facility | | $212.27 | $419.84 | $944.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.87 / $370.87 / $463.59
| Professional | | $370.87 | $370.87 | $463.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.56 / $190.55 / $437.29
| Professional | | $148.56 | $190.55 | $437.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.65 / $884.21 / $1,350.71
| Facility | | $332.65 | $884.21 | $1,350.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.51 / $264.83 / $1,333.82
| Professional | | $235.51 | $264.83 | $1,333.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.68 / $499.69 / $1,071.39
| Facility | | $225.68 | $499.69 | $1,071.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.87 / $370.87 / $463.59
| Professional | | $370.87 | $370.87 | $463.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.95 / $322.95 / $394.74
| Facility | | $322.95 | $322.95 | $394.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.20 / $322.95 / $394.74
| Professional | | $284.20 | $322.95 | $394.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.31 / $215.31 / $430.62
| Facility | | $215.31 | $215.31 | $430.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.33 / $193.78 / $556.22
| Professional | | $145.33 | $193.78 | $556.22 |