- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.10 / $2,068.00 / $6,762.00
| Facility | | $199.10 | $2,068.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.40 / $159.68 / $220.60
| Professional | | $85.40 | $159.68 | $220.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.93 / $192.61 / $750.90
| Facility | | $113.93 | $192.61 | $750.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.99 / $155.11 / $262.33
| Professional | | $81.99 | $155.11 | $262.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.44 / $35.44 / $80.20
| Facility | | $35.44 | $35.44 | $80.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.69 / $179.69 / $179.69
| Facility | | $179.69 | $179.69 | $179.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.35 / $182.17 / $319.80
| Professional | | $98.35 | $182.17 | $319.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $623.10
| Facility | | $55.00 | $55.00 | $623.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.84 / $1,211.35 / $1,418.25
| Professional | | $657.84 | $1,211.35 | $1,418.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.65 / $170.46 / $320.56
| Facility | | $90.65 | $170.46 | $320.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.80 / $179.69 / $285.86
| Professional | | $114.80 | $179.69 | $285.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.80 / $150.80 / $150.80
| Professional | | $150.80 | $150.80 | $150.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.65 / $170.46 / $345.95
| Facility | | $90.65 | $170.46 | $345.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.00 / $190.45 / $332.70
| Professional | | $102.00 | $190.45 | $332.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.27 / $191.23 / $292.81
| Professional | | $139.27 | $191.23 | $292.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.41 / $156.19 / $221.51
| Professional | | $139.41 | $156.19 | $221.51 |