- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.04 / $163.04 / $630.97
| Facility | | $163.04 | $163.04 | $630.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.29 / $172.63 / $250.33
| Professional | | $157.29 | $172.63 | $250.33 |
- 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
- $278.01 / $365.10 / $365.10
| Professional | | $278.01 | $365.10 | $365.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.64 / $274.64 / $427.99
| Facility | | $274.64 | $274.64 | $427.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.49 / $200.49 / $374.77
| Professional | | $200.49 | $200.49 | $374.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.75 / $427.99 / $813.18
| Professional | | $393.75 | $427.99 | $813.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.83 / $273.83 / $273.83
| Professional | | $273.83 | $273.83 | $273.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.04 / $163.04 / $630.97
| Facility | | $163.04 | $163.04 | $630.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.29 / $172.63 / $296.73
| Professional | | $157.29 | $172.63 | $296.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.80 / $583.70 / $843.20
| Professional | | $289.80 | $583.70 | $843.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.64 / $274.64 / $427.99
| Facility | | $274.64 | $274.64 | $427.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.49 / $200.49 / $471.38
| Professional | | $200.49 | $200.49 | $471.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.46 / $174.46 / $347.51
| Facility | | $174.46 | $174.46 | $347.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.46 / $347.51 / $407.37
| Professional | | $174.46 | $347.51 | $407.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.45 / $213.52 / $329.26
| Professional | | $171.45 | $213.52 | $329.26 |