- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.10 / $159.10 / $615.72
| Facility | | $159.10 | $159.10 | $615.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.19 / $176.03 / $215.88
| Professional | | $135.19 | $176.03 | $215.88 |
- 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
- $294.37 / $386.59 / $386.59
| Professional | | $294.37 | $386.59 | $386.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.87 / $215.87 / $345.48
| Facility | | $215.87 | $215.87 | $345.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.59 / $157.59 / $302.51
| Professional | | $157.59 | $157.59 | $302.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.83 / $345.48 / $656.41
| Professional | | $317.83 | $345.48 | $656.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.94 / $289.94 / $289.94
| Professional | | $289.94 | $289.94 | $289.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.10 / $159.10 / $615.72
| Facility | | $159.10 | $159.10 | $615.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.19 / $182.80 / $259.24
| Professional | | $135.19 | $182.80 | $259.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.00 / $471.20 / $680.60
| Professional | | $234.00 | $471.20 | $680.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.87 / $215.87 / $345.48
| Facility | | $215.87 | $215.87 | $345.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.59 / $157.59 / $444.38
| Professional | | $157.59 | $157.59 | $444.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.39 / $367.96 / $367.96
| Facility | | $276.39 | $367.96 | $367.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.39 / $367.96 / $367.96
| Professional | | $276.39 | $367.96 | $367.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.08 / $192.86 / $337.77
| Professional | | $146.08 | $192.86 | $337.77 |