- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.49 / $324.08 / $358.56
| Facility | | $40.49 | $324.08 | $358.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.08 / $418.55 / $610.66
| Professional | | $324.08 | $418.55 | $610.66 |
- 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
- $568.30 / $617.78 / $617.78
| Professional | | $568.30 | $617.78 | $617.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.78 / $647.80 / $647.80
| Facility | | $617.78 | $647.80 | $647.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.90 / $472.90 / $713.63
| Professional | | $472.90 | $472.90 | $713.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.36 / $617.78 / $1,173.78
| Professional | | $568.36 | $617.78 | $1,173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.45 / $586.89 / $739.38
| Professional | | $432.45 | $586.89 | $739.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.49 / $324.08 / $1,254.19
| Facility | | $40.49 | $324.08 | $1,254.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.08 / $409.59 / $645.64
| Professional | | $324.08 | $409.59 | $645.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.10 / $553.29 / $1,582.20
| Professional | | $461.10 | $553.29 | $1,582.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.78 / $647.80 / $647.80
| Facility | | $617.78 | $647.80 | $647.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.90 / $472.90 / $720.76
| Professional | | $472.90 | $472.90 | $720.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.39 / $710.39 / $959.68
| Facility | | $710.39 | $710.39 | $959.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $695.15 / $710.39 / $959.68
| Professional | | $695.15 | $710.39 | $959.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.67 / $550.27 / $916.06
| Professional | | $370.67 | $550.27 | $916.06 |