- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.66 / $191.19 / $41,239.92
| Facility | | $136.66 | $191.19 | $41,239.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $136.66 / $164.84
| Professional | | $136.66 | $136.66 | $164.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.11 / $366.28 / $683.35
| Facility | | $118.11 | $366.28 | $683.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $136.66 / $586.87
| Professional | | $136.66 | $136.66 | $586.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.51 / $167.83 / $326.08
| Facility | | $146.51 | $167.83 | $326.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.77 / $228.48 / $283.82
| Professional | | $162.77 | $228.48 | $283.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.91 / $136.66 / $136.66
| Facility | | $132.91 | $136.66 | $136.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $136.66 / $136.66
| Professional | | $136.66 | $136.66 | $136.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.22 / $215.24 / $8,090.00
| Facility | | $136.22 | $215.24 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $136.66 / $136.66
| Professional | | $136.66 | $136.66 | $136.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $136.66 / $158.18
| Professional | | $136.66 | $136.66 | $158.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.74 / $200.74 / $1,316.31
| Facility | | $200.74 | $200.74 | $1,316.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.79 / $683.35 / $683.35
| Facility | | $181.79 | $683.35 | $683.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $144.87 / $586.87
| Professional | | $136.66 | $144.87 | $586.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $143.50 / $205.01
| Professional | | $136.66 | $143.50 | $205.01 |