- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.86 / $84.86 / $125.45
| Facility | | $84.86 | $84.86 | $125.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.44 / $107.71 / $141.81
| Professional | | $76.44 | $107.71 | $141.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.75 / $129.46 / $224.17
| Professional | | $124.75 | $129.46 | $224.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.37 / $140.37 / $140.37
| Facility | | $140.37 | $140.37 | $140.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.62 / $126.25 / $220.66
| Professional | | $82.62 | $126.25 | $220.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.09 / $201.56 / $257.52
| Professional | | $149.09 | $201.56 | $257.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.38 / $127.38 / $131.19
| Professional | | $127.38 | $127.38 | $131.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.86 / $84.86 / $125.45
| Facility | | $84.86 | $84.86 | $125.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.34 / $117.94 / $258.43
| Professional | | $78.34 | $117.94 | $258.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.30 / $129.30 / $261.89
| Professional | | $129.30 | $129.30 | $261.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.37 / $140.37 / $140.37
| Facility | | $140.37 | $140.37 | $140.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.02 / $128.18 / $227.86
| Professional | | $83.02 | $128.18 | $227.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.26 / $86.52 / $121.72
| Facility | | $80.26 | $86.52 | $121.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.26 / $115.76 / $126.95
| Professional | | $80.26 | $115.76 | $126.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.12 / $140.30 / $242.08
| Professional | | $106.12 | $140.30 | $242.08 |