- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.90 / $1,745.32 / $2,684.38
| Facility | | $519.90 | $1,745.32 | $2,684.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.90 / $519.90 / $962.77
| Professional | | $188.90 | $519.90 | $962.77 |
- 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
- $500.64 / $500.64 / $500.64
| Professional | | $500.64 | $500.64 | $500.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.11 / $948.08 / $2,129.73
| Facility | | $609.11 | $948.08 | $2,129.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.55 / $592.83 / $1,451.54
| Professional | | $133.55 | $592.83 | $1,451.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.91 / $866.50 / $1,219.52
| Professional | | $381.91 | $866.50 | $1,219.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.39 / $965.41 / $1,292.61
| Facility | | $282.39 | $965.41 | $1,292.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.57 / $1,745.32 / $2,650.84
| Facility | | $545.57 | $1,745.32 | $2,650.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.00 / $545.57 / $2,650.84
| Professional | | $425.00 | $545.57 | $2,650.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $949.94 / $962.77 / $1,283.70
| Professional | | $949.94 | $962.77 | $1,283.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.65 / $1,067.82 / $2,129.73
| Facility | | $624.65 | $1,067.82 | $2,129.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.04 / $607.61 / $1,451.54
| Professional | | $156.04 | $607.61 | $1,451.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.01 / $641.85 / $641.85
| Facility | | $319.01 | $641.85 | $641.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.01 / $641.85 / $641.85
| Professional | | $319.01 | $641.85 | $641.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.58 / $332.71 / $802.31
| Professional | | $269.58 | $332.71 | $802.31 |