- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.31 / $79.06 / $79.06
| Facility | | $75.31 | $79.06 | $79.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.36 / $79.06 / $107.16
| Professional | | $71.36 | $79.06 | $107.16 |
- 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
- $12.66 / $126.57 / $126.57
| Professional | | $12.66 | $126.57 | $126.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.60 / $96.60 / $194.14
| Facility | | $96.60 | $96.60 | $194.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.11 / $96.60 / $195.94
| Professional | | $82.11 | $96.60 | $195.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.44 / $116.44 / $126.57
| Professional | | $116.44 | $116.44 | $126.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.50 / $110.50 / $110.50
| Professional | | $110.50 | $110.50 | $110.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.06 / $79.06 / $79.06
| Facility | | $79.06 | $79.06 | $79.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.36 / $79.06 / $433.37
| Professional | | $71.36 | $79.06 | $433.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.60 / $96.60 / $194.14
| Facility | | $96.60 | $96.60 | $194.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.11 / $96.60 / $195.94
| Professional | | $82.11 | $96.60 | $195.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.76 / $136.76 / $142.08
| Facility | | $136.76 | $136.76 | $142.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.76 / $136.76 / $142.38
| Professional | | $136.76 | $136.76 | $142.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.19 / $89.61 / $179.22
| Professional | | $71.19 | $89.61 | $179.22 |