- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.98 / $1,422.40 / $2,161.00
| Facility | | $219.98 | $1,422.40 | $2,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.42 / $425.00 / $507.77
| Professional | | $359.42 | $425.00 | $507.77 |
- 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
- $155.12 / $449.20 / $781.81
| Professional | | $155.12 | $449.20 | $781.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.10 / $729.21 / $1,476.85
| Facility | | $211.10 | $729.21 | $1,476.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.48 / $534.13 / $855.21
| Professional | | $314.48 | $534.13 | $855.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.51 / $619.15 / $1,079.45
| Professional | | $356.51 | $619.15 | $1,079.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.44 / $296.95 / $1,763.54
| Facility | | $131.44 | $296.95 | $1,763.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $740.70 / $740.70 / $740.70
| Professional | | $740.70 | $740.70 | $740.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.98 / $1,422.40 / $2,097.00
| Facility | | $219.98 | $1,422.40 | $2,097.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.42 / $425.00 / $1,362.00
| Professional | | $359.42 | $425.00 | $1,362.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.79 / $877.40 / $1,350.40
| Professional | | $620.79 | $877.40 | $1,350.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.83 / $673.83 / $1,476.85
| Facility | | $193.83 | $673.83 | $1,476.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.48 / $534.47 / $811.71
| Professional | | $314.48 | $534.47 | $811.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.00 / $460.00 / $460.00
| Facility | | $460.00 | $460.00 | $460.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.00 / $460.00 / $460.00
| Professional | | $460.00 | $460.00 | $460.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.27 / $456.26 / $771.92
| Professional | | $355.27 | $456.26 | $771.92 |