- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.47 / $141.47 / $547.53
| Facility | | $141.47 | $141.47 | $547.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.53 / $156.53 / $216.73
| Professional | | $134.53 | $156.53 | $216.73 |
- 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
- $261.77 / $343.78 / $343.78
| Professional | | $261.77 | $343.78 | $343.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.98 / $212.98 / $343.78
| Facility | | $212.98 | $212.98 | $343.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $155.47 / $301.02
| Professional | | $155.47 | $155.47 | $301.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.27 / $343.78 / $653.17
| Professional | | $316.27 | $343.78 | $653.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.00 / $354.00 / $354.00
| Facility | | $354.00 | $354.00 | $354.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.47 / $141.47 / $547.53
| Facility | | $141.47 | $141.47 | $547.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.53 / $165.56 / $525.36
| Professional | | $134.53 | $165.56 | $525.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.00 / $161.69 / $556.90
| Professional | | $123.00 | $161.69 | $556.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.98 / $212.98 / $343.78
| Facility | | $212.98 | $212.98 | $343.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $155.47 / $408.38
| Professional | | $155.47 | $155.47 | $408.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.79 / $327.20 / $327.20
| Facility | | $245.79 | $327.20 | $327.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.79 / $327.20 / $335.26
| Professional | | $245.79 | $327.20 | $335.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.57 / $173.22 / $310.02
| Professional | | $131.57 | $173.22 | $310.02 |