- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.65 / $363.86 / $926.67
| Facility | | $107.65 | $363.86 | $926.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.80 / $107.65 / $130.29
| Professional | | $72.80 | $107.65 | $130.29 |
- 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
- $50.70 / $50.70 / $50.70
| Professional | | $50.70 | $50.70 | $50.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.87 / $144.15 / $438.99
| Facility | | $4.87 | $144.15 | $438.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.76 / $119.36 / $171.57
| Professional | | $45.76 | $119.36 | $171.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.76 / $79.20 / $181.77
| Professional | | $61.76 | $79.20 | $181.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.20 / $861.20 / $861.20
| Facility | | $861.20 | $861.20 | $861.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.32 / $321.82 / $593.15
| Facility | | $143.32 | $321.82 | $593.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.80 / $107.65 / $204.54
| Professional | | $72.80 | $107.65 | $204.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.87 / $144.15 / $438.99
| Facility | | $4.87 | $144.15 | $438.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.42 / $119.36 / $158.94
| Professional | | $44.42 | $119.36 | $158.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.49 / $53.49 / $55.09
| Facility | | $53.49 | $53.49 | $55.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.49 / $53.49 / $55.09
| Professional | | $53.49 | $53.49 | $55.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,126.83 / $2,134.58 / $2,775.87
| Facility | | $1,126.83 | $2,134.58 | $2,775.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.18 / $81.97 / $166.82
| Professional | | $39.18 | $81.97 | $166.82 |