- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.88 / $714.92 / $714.92
| Facility | | $680.88 | $714.92 | $714.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.40 / $755.38 / $995.06
| Professional | | $516.40 | $755.38 | $995.06 |
- 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
- $93.86 / $93.86 / $93.86
| Professional | | $93.86 | $93.86 | $93.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.80 / $1,017.80 / $1,017.80
| Facility | | $1,017.80 | $1,017.80 | $1,017.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.60 / $750.60 / $750.60
| Professional | | $750.60 | $750.60 | $750.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.92 / $714.92 / $714.92
| Facility | | $714.92 | $714.92 | $714.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.15 / $755.38 / $927.12
| Professional | | $549.15 | $755.38 | $927.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.80 / $1,017.80 / $1,017.80
| Facility | | $1,017.80 | $1,017.80 | $1,017.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.60 / $750.60 / $4,077.00
| Professional | | $750.60 | $750.60 | $4,077.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,236.00 / $1,236.00 / $1,236.00
| Facility | | $1,236.00 | $1,236.00 | $1,236.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,236.00 / $1,236.00 / $1,260.72
| Professional | | $1,236.00 | $1,236.00 | $1,260.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.85 / $103.90 / $866.55
| Professional | | $60.85 | $103.90 | $866.55 |