- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $168.73 / $740.02
| Facility | | $85.00 | $168.73 | $740.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.39 / $120.00 / $124.85
| Professional | | $72.39 | $120.00 | $124.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $60.00 / $60.00
| Professional | | $60.00 | $60.00 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.25 / $391.20 / $8,639.91
| Facility | | $301.25 | $391.20 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.00 / $78.00 / $78.00
| Professional | | $78.00 | $78.00 | $78.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.73 / $130.00 / $315.20
| Facility | | $65.73 | $130.00 | $315.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.06 / $108.75 / $149.36
| Professional | | $47.06 | $108.75 | $149.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.00 / $59.00 / $135.40
| Professional | | $46.00 | $59.00 | $135.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.13 / $250.90 / $595.12
| Facility | | $186.13 | $250.90 | $595.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $60.00 / $66.00
| Professional | | $60.00 | $60.00 | $66.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.50 / $255.00 / $430.35
| Facility | | $93.50 | $255.00 | $430.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.68 / $120.00 / $413.00
| Professional | | $71.68 | $120.00 | $413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.00 / $133.16 / $331.41
| Facility | | $65.00 | $133.16 | $331.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.06 / $108.75 / $143.52
| Professional | | $47.06 | $108.75 | $143.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.75 / $100.00 / $100.00
| Professional | | $76.75 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.25 / $60.00 / $170.00
| Professional | | $39.25 | $60.00 | $170.00 |