- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.14 / $346.19 / $383.02
| Facility | | $293.14 | $346.19 | $383.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.30 / $405.11 / $737.30
| Professional | | $326.30 | $405.11 | $737.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $720.65 / $720.65 / $960.87
| Professional | | $720.65 | $720.65 | $960.87 |
- 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
- $607.07 / $659.93 / $659.93
| Professional | | $607.07 | $659.93 | $659.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.58 / $736.58 / $761.97
| Facility | | $736.58 | $736.58 | $761.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.70 / $537.70 / $855.00
| Professional | | $537.70 | $537.70 | $855.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $607.14 / $659.93 / $1,253.86
| Professional | | $607.14 | $659.93 | $1,253.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.95 / $708.36 / $789.78
| Professional | | $461.95 | $708.36 | $789.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.14 / $350.05 / $350.05
| Facility | | $293.14 | $350.05 | $350.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.48 / $405.11 / $737.30
| Professional | | $248.48 | $405.11 | $737.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,362.70 / $1,657.30 / $1,657.30
| Professional | | $1,362.70 | $1,657.30 | $1,657.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.58 / $736.58 / $761.97
| Facility | | $736.58 | $736.58 | $761.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.70 / $537.70 / $863.55
| Professional | | $537.70 | $537.70 | $863.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.84 / $758.84 / $851.34
| Facility | | $758.84 | $758.84 | $851.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.07 / $758.84 / $851.34
| Professional | | $750.07 | $758.84 | $851.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.93 / $595.02 / $972.50
| Professional | | $418.93 | $595.02 | $972.50 |