- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.20 / $81.20 / $537.35
| Facility | | $81.20 | $81.20 | $537.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.22 / $103.92 / $300.00
| Professional | | $77.22 | $103.92 | $300.00 |
- 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
- $150.25 / $197.31 / $197.31
| Professional | | $150.25 | $197.31 | $197.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.67 / $112.67 / $197.31
| Facility | | $112.67 | $112.67 | $197.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.25 / $82.25 / $172.78
| Professional | | $82.25 | $82.25 | $172.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.53 / $197.31 / $374.89
| Professional | | $181.53 | $197.31 | $374.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.85 / $57.85 / $725.62
| Facility | | $57.85 | $57.85 | $725.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.25 / $157.85 / $167.72
| Professional | | $133.25 | $157.85 | $167.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.20 / $314.27 / $537.35
| Facility | | $81.20 | $314.27 | $537.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.22 / $105.85 / $300.00
| Professional | | $77.22 | $105.85 | $300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.90 / $76.09 / $388.80
| Professional | | $65.90 | $76.09 | $388.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.67 / $112.67 / $197.31
| Facility | | $112.67 | $112.67 | $197.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.25 / $82.25 / $234.38
| Professional | | $82.25 | $82.25 | $234.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.46 / $187.81 / $187.81
| Facility | | $136.46 | $187.81 | $187.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.46 / $187.81 / $192.45
| Professional | | $136.46 | $187.81 | $192.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.53 / $98.86 / $172.40
| Professional | | $74.53 | $98.86 | $172.40 |