- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.23 / $324.47 / $909.33
| Facility | | $122.23 | $324.47 | $909.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.71 / $129.63 / $222.24
| Professional | | $103.71 | $129.63 | $222.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $98.16 / $164.83
| Professional | | $5.00 | $98.16 | $164.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $185.20 / $185.20
| Facility | | $80.00 | $185.20 | $185.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.36 / $406.88 / $825.86
| Facility | | $123.36 | $406.88 | $825.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.41 / $103.63 / $289.13
| Professional | | $84.41 | $103.63 | $289.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.32 / $879.70 / $879.70
| Facility | | $296.32 | $879.70 | $879.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.00 / $926.00 / $1,389.00
| Professional | | $926.00 | $926.00 | $1,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.68 / $185.20 / $277.80
| Facility | | $116.68 | $185.20 | $277.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.20 / $185.20 / $231.50
| Professional | | $185.20 | $185.20 | $231.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.38 / $222.24 / $416.70
| Professional | | $120.38 | $222.24 | $416.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.80 / $198.63 / $666.79
| Facility | | $125.80 | $198.63 | $666.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.22 / $166.68 / $281.20
| Professional | | $85.22 | $166.68 | $281.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.78 / $185.20 / $222.24
| Facility | | $77.78 | $185.20 | $222.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.78 / $77.78 / $118.53
| Professional | | $77.78 | $77.78 | $118.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.23 / $185.20 / $250.02
| Professional | | $72.23 | $185.20 | $250.02 |