- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.47 / $284.27 / $649.63
| Facility | | $154.47 | $284.27 | $649.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.12 / $217.57 / $483.14
| Professional | | $151.12 | $217.57 | $483.14 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $289.00 / $830.20 / $874.30
| Professional | 25 | $289.00 | $830.20 | $874.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.35 / $389.52 / $927.58
| Facility | | $90.35 | $389.52 | $927.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.01 / $346.09 / $1,202.95
| Professional | | $183.01 | $346.09 | $1,202.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.10 / $277.69 / $495.30
| Facility | | $216.10 | $277.69 | $495.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.77 / $315.68 / $559.42
| Professional | | $184.77 | $315.68 | $559.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.36 / $361.77 / $633.71
| Professional | | $218.36 | $361.77 | $633.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.00 / $281.86 / $6,679.00
| Facility | | $70.00 | $281.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.03 / $311.45 / $488.06
| Professional | | $175.03 | $311.45 | $488.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.01 / $375.85 / $690.58
| Professional | | $231.01 | $375.85 | $690.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.81 / $380.13 / $851.76
| Professional | | $251.81 | $380.13 | $851.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $927.58 / $927.58
| Facility | | $100.00 | $927.58 | $927.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.64 / $472.11 / $1,741.13
| Professional | | $270.64 | $472.11 | $1,741.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.34 / $445.34 / $445.34
| Professional | | $445.34 | $445.34 | $445.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.62 / $358.48 / $769.65
| Professional | | $263.62 | $358.48 | $769.65 |