- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.52 / $178.52 / $690.87
| Facility | | $178.52 | $178.52 | $690.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.66 / $197.51 / $264.47
| Professional | | $156.66 | $197.51 | $264.47 |
- 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
- $330.30 / $433.78 / $433.78
| Professional | | $330.30 | $433.78 | $433.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.60 / $252.60 / $400.31
| Facility | | $252.60 | $252.60 | $400.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.40 / $184.40 / $466.50
| Professional | | $184.40 | $184.40 | $466.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.29 / $400.31 / $760.59
| Professional | | $368.29 | $400.31 | $760.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.13 / $309.13 / $325.33
| Professional | | $309.13 | $309.13 | $325.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.52 / $178.52 / $690.87
| Facility | | $178.52 | $178.52 | $690.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.65 / $206.85 / $264.47
| Professional | | $156.65 | $206.85 | $264.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.10 / $546.00 / $788.70
| Professional | | $271.10 | $546.00 | $788.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.60 / $252.60 / $400.31
| Facility | | $252.60 | $252.60 | $400.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.40 / $184.40 / $466.50
| Professional | | $184.40 | $184.40 | $466.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.14 / $412.88 / $412.88
| Facility | | $310.14 | $412.88 | $412.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.14 / $412.88 / $412.88
| Professional | | $310.14 | $412.88 | $412.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.39 / $218.79 / $379.00
| Professional | | $167.39 | $218.79 | $379.00 |