- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.96 / $194.44 / $350.00
| Facility | | $100.96 | $194.44 | $350.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.28 / $105.94 / $350.00
| Professional | | $45.28 | $105.94 | $350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.64 / $124.64 / $324.06
| Facility | | $124.64 | $124.64 | $324.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.86 / $51.75 / $211.53
| Professional | | $49.86 | $51.75 | $211.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.78 / $124.64 / $124.64
| Facility | | $74.78 | $124.64 | $124.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.99 / $124.64 / $124.64
| Professional | | $90.99 | $124.64 | $124.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.02 / $263.32 / $448.32
| Facility | | $159.02 | $263.32 | $448.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.47 / $135.78 / $402.20
| Professional | | $50.47 | $135.78 | $402.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.34 / $162.03 / $332.00
| Facility | | $55.34 | $162.03 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.25 / $130.04 / $228.09
| Professional | | $87.25 | $130.04 | $228.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.71 / $118.41 / $222.30
| Professional | | $99.71 | $118.41 | $222.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $250.00 / $250.00
| Facility | | $250.00 | $250.00 | $250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $263.32 / $597.00
| Facility | | $13.73 | $263.32 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $124.64 / $341.61
| Professional | | $55.00 | $124.64 | $341.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.35 / $74.78 / $193.19
| Professional | | $52.35 | $74.78 | $193.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.12 / $132.12 / $132.12
| Facility | | $132.12 | $132.12 | $132.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.94 / $124.64 / $146.69
| Professional | | $105.94 | $124.64 | $146.69 |