- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.73 / $480.33 / $480.33
| Facility | | $76.73 | $480.33 | $480.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.97 / $106.85 / $307.20
| Professional | | $72.97 | $106.85 | $307.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.82 / $158.47 / $186.43
| Professional | | $139.82 | $158.47 | $186.43 |
- 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
- $141.96 / $186.43 / $186.43
| Professional | | $141.96 | $186.43 | $186.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.47 / $120.81 / $186.43
| Facility | | $118.47 | $120.81 | $186.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.19 / $88.19 / $163.25
| Professional | | $88.19 | $88.19 | $163.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.52 / $186.43 / $354.22
| Professional | | $171.52 | $186.43 | $354.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.52 / $524.52 / $861.64
| Facility | | $524.52 | $524.52 | $861.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.90 / $132.86 / $158.47
| Professional | | $125.90 | $132.86 | $158.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.73 / $480.33 / $480.33
| Facility | | $76.73 | $480.33 | $480.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.73 / $106.85 / $239.56
| Professional | | $76.73 | $106.85 | $239.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.00 / $95.90 / $367.30
| Professional | | $73.00 | $95.90 | $367.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.47 / $120.81 / $186.43
| Facility | | $118.47 | $120.81 | $186.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.19 / $88.19 / $221.63
| Professional | | $88.19 | $88.19 | $221.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.71 / $177.45 / $177.45
| Facility | | $135.71 | $177.45 | $177.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.71 / $177.45 / $181.83
| Professional | | $135.71 | $177.45 | $181.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.45 / $94.85 / $162.90
| Professional | | $73.45 | $94.85 | $162.90 |