- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.62 / $281.11 / $471.07
| Facility | | $105.62 | $281.11 | $471.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.00 / $105.62 / $159.66
| Professional | | $99.00 | $105.62 | $159.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.49 / $172.20 / $382.67
| Facility | | $111.49 | $172.20 | $382.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $128.33 / $484.68
| Professional | | $73.33 | $128.33 | $484.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.54 / $331.23 / $600.04
| Facility | | $215.54 | $331.23 | $600.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.89 / $114.89 / $141.84
| Professional | | $114.89 | $114.89 | $141.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.33 / $109.02 / $278.04
| Facility | | $95.33 | $109.02 | $278.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.40 / $128.88 / $318.45
| Professional | | $73.40 | $128.88 | $318.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.43 / $176.43 / $207.57
| Professional | | $176.43 | $176.43 | $207.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $397.42
| Professional | | $122.22 | $122.22 | $397.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.66 / $580.54 / $580.54
| Facility | | $212.66 | $580.54 | $580.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $90.53 / $611.10
| Professional | | $73.33 | $90.53 | $611.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.33 / $73.33 / $73.33
| Facility | | $73.33 | $73.33 | $73.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $90.53 / $232.96
| Professional | | $73.33 | $90.53 | $232.96 |