- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.03 / $118.14 / $486.27
| Facility | | $87.03 | $118.14 | $486.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.41 / $88.23 / $219.76
| Professional | | $76.41 | $88.23 | $219.76 |
- 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
- $82.93 / $86.06 / $175.72
| Professional | | $82.93 | $86.06 | $175.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.46 / $95.46 / $95.46
| Facility | | $95.46 | $95.46 | $95.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.80 / $101.96 / $173.72
| Professional | | $77.80 | $101.96 | $173.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.97 / $117.37 / $177.60
| Professional | | $93.97 | $117.37 | $177.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.48 / $137.11 / $458.75
| Facility | | $88.48 | $137.11 | $458.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.03 / $122.73 / $486.27
| Facility | | $87.03 | $122.73 | $486.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.47 / $100.75 / $219.76
| Professional | | $78.47 | $100.75 | $219.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.00 / $115.80 / $200.70
| Professional | | $28.00 | $115.80 | $200.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.46 / $95.46 / $95.46
| Facility | | $95.46 | $95.46 | $95.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.80 / $101.96 / $178.32
| Professional | | $77.80 | $101.96 | $178.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $102.41
| Facility | | $81.28 | $81.28 | $102.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.42 / $82.10 / $83.85
| Professional | | $78.42 | $82.10 | $83.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.33 / $92.31 / $157.10
| Professional | | $74.33 | $92.31 | $157.10 |