- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.06 / $327.77 / $731.91
| Facility | | $113.06 | $327.77 | $731.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.71 / $123.23 / $145.87
| Professional | | $106.71 | $123.23 | $145.87 |
- 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
- $150.22 / $155.88 / $155.88
| Professional | | $150.22 | $155.88 | $155.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.27 / $319.26 / $537.79
| Facility | | $127.27 | $319.26 | $537.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.10 / $148.57 / $262.75
| Professional | | $111.10 | $148.57 | $262.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.38 / $159.32 / $229.96
| Professional | | $148.38 | $159.32 | $229.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.70 / $290.75 / $528.70
| Facility | | $73.70 | $290.75 | $528.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.85 / $327.77 / $731.91
| Facility | | $134.85 | $327.77 | $731.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.71 / $123.23 / $224.00
| Professional | | $106.71 | $123.23 | $224.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.67 / $171.28 / $309.00
| Professional | | $111.67 | $171.28 | $309.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.41 / $292.94 / $537.79
| Facility | | $126.41 | $292.94 | $537.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.10 / $149.55 / $270.58
| Professional | | $111.10 | $149.55 | $270.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.05 / $129.05 / $129.05
| Facility | | $129.05 | $129.05 | $129.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.05 / $129.05 / $131.63
| Professional | | $129.05 | $129.05 | $131.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.05 / $156.19 / $265.31
| Professional | | $99.05 | $156.19 | $265.31 |