- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $102.33 / $154.88
| Facility | | $74.13 | $102.33 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $72.44 / $112.20
| Professional | | $60.26 | $72.44 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $89.13 / $91.20
| Professional | | $70.79 | $89.13 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $77.62 / $141.25
| Professional | | $64.57 | $77.62 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $104.71
| Facility | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $117.49
| Professional | | $104.71 | $104.71 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $53,703.18
| Facility | | $114.82 | $114.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $107.15 / $218.78
| Professional | | $58.88 | $107.15 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $75.86 / $181.97
| Facility | | $43.65 | $75.86 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $141.25 / $194.98
| Professional | | $100.00 | $141.25 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $77.62 / $77.62
| Facility | | $60.26 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $91.20 / $151.36
| Professional | | $66.07 | $91.20 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $117.49 / $131.83
| Professional | | $93.33 | $117.49 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $89.13 / $181.97
| Professional | | $54.95 | $89.13 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $70.79 / $95.50
| Facility | | $60.26 | $70.79 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $91.20 / $154.88
| Professional | | $57.54 | $91.20 | $154.88 |