- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.66 / $81.66 / $1,183.00
| Facility | | $81.66 | $81.66 | $1,183.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.15 / $89.76 / $420.08
| Professional | | $74.15 | $89.76 | $420.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.88 / $508.66 / $508.66
| Facility | | $195.88 | $508.66 | $508.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.99 / $144.47 / $746.29
| Professional | | $82.99 | $144.47 | $746.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.79 / $732.71 / $1,228.06
| Facility | | $605.79 | $732.71 | $1,228.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.49 / $166.31 / $216.46
| Professional | | $118.49 | $166.31 | $216.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.00 / $462.00 / $824.27
| Facility | | $462.00 | $462.00 | $824.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.27 / $126.59 / $241.70
| Professional | | $80.27 | $126.59 | $241.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.00 / $264.93 / $433.65
| Facility | | $236.00 | $264.93 | $433.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.03 / $84.81 / $153.68
| Professional | | $47.03 | $84.81 | $153.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.27 / $197.38 / $262.19
| Professional | | $105.27 | $197.38 | $262.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.00 / $203.00 / $203.00
| Facility | | $203.00 | $203.00 | $203.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.10 / $136.24 / $188.62
| Professional | | $133.10 | $136.24 | $188.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.88 / $508.66 / $508.66
| Facility | | $195.88 | $508.66 | $508.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.52 / $144.47 / $746.29
| Professional | | $82.52 | $144.47 | $746.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.27 / $211.43 / $1,175.02
| Facility | | $61.27 | $211.43 | $1,175.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.01 / $116.76 / $220.89
| Professional | | $79.01 | $116.76 | $220.89 |