- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.18 / $1,037.40 / $1,307.79
| Facility | | $314.18 | $1,037.40 | $1,307.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.18 / $314.18 / $433.26
| Professional | | $314.18 | $314.18 | $433.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.49 / $1,064.98 / $2,042.90
| Facility | | $473.49 | $1,064.98 | $2,042.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.46 / $811.20 / $1,283.83
| Facility | | $343.46 | $811.20 | $1,283.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $319.00 / $319.00
| Facility | | $319.00 | $319.00 | $319.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.02 / $52.02 / $52.02
| Professional | | $52.02 | $52.02 | $52.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.18 / $339.31 / $891.77
| Facility | | $314.18 | $339.31 | $891.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.18 / $339.31 / $891.77
| Facility | | $314.18 | $339.31 | $891.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.02 / $52.02 / $52.02
| Professional | | $52.02 | $52.02 | $52.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.00 / $16.00 / $22.40
| Professional | | $16.00 | $16.00 | $22.40 |