- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.33 / $163.28 / $192.11
| Facility | | $131.33 | $163.28 | $192.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.59 / $128.86 / $243.92
| Professional | | $99.59 | $128.86 | $243.92 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Professional | 25 | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.17 / $672.17 / $672.17
| Facility | | $672.17 | $672.17 | $672.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.82 / $197.25 / $870.26
| Professional | | $115.82 | $197.25 | $870.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.41 / $233.06 / $268.82
| Facility | | $185.41 | $233.06 | $268.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.06 / $238.47 / $378.05
| Professional | | $139.06 | $238.47 | $378.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.00 / $132.50 / $329.00
| Professional | | $77.00 | $132.50 | $329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.71 / $159.00 / $182.27
| Facility | | $136.71 | $159.00 | $182.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.53 / $136.71 / $182.27
| Professional | | $127.53 | $136.71 | $182.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.74 / $292.75 / $420.11
| Professional | | $141.74 | $292.75 | $420.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.74 / $119.03 / $150.00
| Facility | | $90.74 | $119.03 | $150.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.74 / $119.03 / $158.71
| Professional | | $90.74 | $119.03 | $158.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.17 / $672.17 / $672.17
| Facility | | $672.17 | $672.17 | $672.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.30 / $176.55 / $966.24
| Professional | | $110.30 | $176.55 | $966.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.74 / $148.77 / $262.95
| Professional | | $103.74 | $148.77 | $262.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.25 / $169.13 / $424.53
| Professional | | $109.25 | $169.13 | $424.53 |