- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.91 / $136.91 / $529.88
| Facility | | $136.91 | $136.91 | $529.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.19 / $151.47 / $184.00
| Professional | | $130.19 | $151.47 | $184.00 |
- 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
- $253.32 / $332.68 / $332.68
| Professional | | $253.32 | $332.68 | $332.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.96 / $227.96 / $332.68
| Facility | | $227.96 | $227.96 | $332.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.41 / $166.41 / $291.31
| Professional | | $166.41 | $166.41 | $291.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.07 / $332.68 / $632.09
| Professional | | $306.07 | $332.68 | $632.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.91 / $136.91 / $529.88
| Facility | | $136.91 | $136.91 | $529.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.19 / $157.31 / $216.28
| Professional | | $130.19 | $157.31 | $216.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.50 / $474.40 / $655.40
| Professional | | $412.50 | $474.40 | $655.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.96 / $227.96 / $332.68
| Facility | | $227.96 | $227.96 | $332.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.41 / $166.41 / $395.25
| Professional | | $166.41 | $166.41 | $395.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.85 / $316.64 / $316.64
| Facility | | $237.85 | $316.64 | $316.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.85 / $316.64 / $324.39
| Professional | | $237.85 | $316.64 | $324.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.58 / $165.97 / $300.01
| Professional | | $126.58 | $165.97 | $300.01 |