- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.93 / $74.93 / $87.45
| Facility | | $74.93 | $74.93 | $87.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.93 / $89.15 / $232.00
| Professional | | $74.93 | $89.15 | $232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.34 / $347.60 / $846.55
| Facility | | $97.34 | $347.60 | $846.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.98 / $115.58 / $167.47
| Professional | | $66.98 | $115.58 | $167.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.02 / $221.45 / $285.18
| Facility | | $182.02 | $221.45 | $285.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.97 / $160.99 / $219.88
| Professional | | $115.97 | $160.99 | $219.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.73 / $96.73 / $120.22
| Facility | | $96.73 | $96.73 | $120.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.61 / $96.73 / $198.38
| Professional | | $70.61 | $96.73 | $198.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.85 / $138.85 / $145.79
| Professional | | $138.85 | $138.85 | $145.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.62 / $69.62 / $185.60
| Facility | | $69.62 | $69.62 | $185.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.80 / $92.80 / $92.80
| Professional | | $92.80 | $92.80 | $92.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.60 / $846.55 / $846.55
| Facility | | $347.60 | $846.55 | $846.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.73 / $85.55 / $167.47
| Professional | | $60.73 | $85.55 | $167.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.77 / $85.75 / $165.83
| Professional | | $61.77 | $85.75 | $165.83 |