- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.95 / $1,027.34 / $1,569.41
| Facility | | $303.95 | $1,027.34 | $1,569.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.25 / $303.95 / $2,412.86
| Professional | | $56.25 | $303.95 | $2,412.86 |
- 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
- $258.27 / $292.70 / $292.70
| Professional | | $258.27 | $292.70 | $292.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.11 / $554.34 / $1,245.25
| Facility | | $356.11 | $554.34 | $1,245.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.24 / $346.50 / $848.71
| Professional | | $43.24 | $346.50 | $848.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.63 / $491.58 / $712.98
| Professional | | $191.63 | $491.58 | $712.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $728.44 / $728.44 / $728.44
| Facility | | $728.44 | $728.44 | $728.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.95 / $1,027.34 / $1,549.78
| Facility | | $303.95 | $1,027.34 | $1,549.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.41 / $318.95 / $1,549.78
| Professional | | $236.41 | $318.95 | $1,549.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.37 / $562.88 / $750.50
| Professional | | $555.37 | $562.88 | $750.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.22 / $624.29 / $1,245.25
| Facility | | $365.22 | $624.29 | $1,245.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.52 / $355.07 / $848.71
| Professional | | $50.52 | $355.07 | $848.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.33 / $375.25 / $375.25
| Facility | | $103.33 | $375.25 | $375.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.33 / $375.25 / $375.25
| Professional | | $103.33 | $375.25 | $375.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.58 / $225.15 / $501.03
| Professional | | $88.58 | $225.15 | $501.03 |