- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $891.25
| Facility | | $812.83 | $812.83 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $831.76 / $1,122.02
| Professional | | $562.34 | $831.76 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $26,915.35 / $52,480.75
| Facility | | $10,000.00 | $26,915.35 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $851.14
| Professional | | $724.44 | $724.44 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $275.42 / $371.54
| Professional | | $162.18 | $275.42 | $371.54 |
- 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
- $72.44 / $112.20 / $2,691.53
| Facility | | $72.44 | $112.20 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $114.82 / $389.05
| Professional | | $54.95 | $114.82 | $389.05 |