- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.16 / $468.92 / $664.14
| Facility | | $125.16 | $468.92 | $664.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $118.50 / $206.22
| Professional | | $75.00 | $118.50 | $206.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.60 / $200.58 / $549.17
| Facility | | $129.60 | $200.58 | $549.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.24 / $179.25 / $695.57
| Professional | | $105.24 | $179.25 | $695.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.97 / $398.93 / $697.43
| Facility | | $278.97 | $398.93 | $697.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.07 / $168.07 / $168.07
| Professional | | $168.07 | $168.07 | $168.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.01 / $214.34 / $399.04
| Facility | | $114.01 | $214.34 | $399.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.02 / $168.51 / $457.39
| Professional | | $101.02 | $168.51 | $457.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.97 / $252.97 / $297.62
| Professional | | $252.97 | $252.97 | $297.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.40 / $175.40 / $543.20
| Professional | | $175.40 | $175.40 | $543.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.31 / $275.31 / $478.96
| Facility | | $275.31 | $275.31 | $478.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.10 / $566.10 / $566.10
| Professional | | $566.10 | $566.10 | $566.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.20 / $833.15 / $833.15
| Facility | | $305.20 | $833.15 | $833.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.24 / $107.55 / $877.00
| Professional | | $105.24 | $107.55 | $877.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.24 / $107.55 / $334.32
| Professional | | $105.24 | $107.55 | $334.32 |