- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.07 / $476.95 / $733.59
| Facility | | $142.07 | $476.95 | $733.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.14 / $142.07 / $1,127.82
| Professional | | $108.14 | $142.07 | $1,127.82 |
- 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
- $136.81 / $136.81 / $136.81
| Professional | | $136.81 | $136.81 | $136.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.45 / $259.27 / $582.41
| Facility | | $166.45 | $259.27 | $582.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.81 / $187.47 / $396.95
| Professional | | $80.81 | $187.47 | $396.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.36 / $236.79 / $333.26
| Professional | | $104.36 | $236.79 | $333.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.41 / $374.34 / $762.64
| Facility | | $155.41 | $374.34 | $762.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.66 / $476.95 / $733.59
| Facility | | $180.66 | $476.95 | $733.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.64 / $201.71 / $724.40
| Professional | | $117.64 | $201.71 | $724.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.58 / $263.10 / $350.80
| Professional | | $259.58 | $263.10 | $350.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.65 / $291.81 / $582.41
| Facility | | $170.65 | $291.81 | $582.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.16 / $187.88 / $396.95
| Professional | | $83.16 | $187.88 | $396.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.40 / $175.40 / $242.00
| Facility | | $175.40 | $175.40 | $242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.40 / $175.40 / $242.00
| Professional | | $175.40 | $175.40 | $242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.67 / $105.24 / $245.56
| Professional | | $73.67 | $105.24 | $245.56 |