- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.12 / $120.12 / $30,707.04
| Facility | | $85.12 | $120.12 | $30,707.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $85.12 / $107.25
| Professional | | $85.12 | $85.12 | $107.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.95 / $228.12 / $425.60
| Facility | | $77.95 | $228.12 | $425.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $87.61 / $370.33
| Professional | | $85.12 | $87.61 | $370.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.25 / $104.53 / $203.10
| Facility | | $91.25 | $104.53 | $203.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.38 / $140.02 / $185.20
| Professional | | $101.38 | $140.02 | $185.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.88 / $85.12 / $85.12
| Facility | | $83.88 | $85.12 | $85.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $85.12 / $85.12
| Professional | | $85.12 | $85.12 | $85.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.12 / $134.69 / $8,090.00
| Facility | | $85.12 | $134.69 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $85.12 / $85.12
| Professional | | $85.12 | $85.12 | $85.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $85.12 / $98.52
| Professional | | $85.12 | $85.12 | $98.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,961.15 / $19,207.75 / $34,837.62
| Facility | | $11,961.15 | $19,207.75 | $34,837.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.22 / $425.60 / $425.60
| Facility | | $113.22 | $425.60 | $425.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $90.23 / $370.33
| Professional | | $85.12 | $90.23 | $370.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.52 / $89.94 / $135.38
| Facility | | $80.52 | $89.94 | $135.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.12 / $85.12 / $104.75
| Professional | | $85.12 | $85.12 | $104.75 |