- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.01 / $273.01 / $273.01
| Facility | | $273.01 | $273.01 | $273.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.01 / $238.61 / $257.10
| Professional | | $182.01 | $238.61 | $257.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.00 / $499.27 / $531.00
| Professional | | $451.00 | $499.27 | $531.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.40 / $279.25 / $538.00
| Professional | | $213.40 | $279.25 | $538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.89 / $232.89 / $279.89
| Facility | | $232.89 | $232.89 | $279.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $205.00 / $400.00
| Facility | | $125.00 | $205.00 | $400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.00 / $220.00 / $425.00
| Professional | | $190.00 | $220.00 | $425.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,372.22 / $1,535.20 / $1,535.20
| Facility | | $1,372.22 | $1,535.20 | $1,535.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.01 / $257.10 / $362.68
| Facility | | $182.01 | $257.10 | $362.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.00 / $560.00 / $560.00
| Professional | | $560.00 | $560.00 | $560.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.17 / $494.17 / $494.17
| Facility | | $494.17 | $494.17 | $494.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.01 / $220.00 / $362.68
| Facility | | $182.01 | $220.00 | $362.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.00 / $220.00 / $425.00
| Professional | | $190.00 | $220.00 | $425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.47 / $236.62 / $335.05
| Professional | | $177.47 | $236.62 | $335.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.44 / $272.44 / $272.44
| Professional | | $272.44 | $272.44 | $272.44 |