- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.01 / $102.01 / $394.78
| Facility | | $102.01 | $102.01 | $394.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.09 / $102.01 / $121.75
| Professional | | $86.09 | $102.01 | $121.75 |
- 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
- $173.93 / $228.41 / $228.41
| Professional | | $173.93 | $228.41 | $228.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.31 / $122.31 / $227.66
| Facility | | $122.31 | $122.31 | $227.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.29 / $89.29 / $199.35
| Professional | | $89.29 | $89.29 | $199.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.45 / $227.66 / $432.55
| Professional | | $209.45 | $227.66 | $432.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.24 / $154.24 / $159.88
| Professional | | $154.24 | $154.24 | $159.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.01 / $102.01 / $394.78
| Facility | | $102.01 | $102.01 | $394.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.09 / $108.01 / $185.66
| Professional | | $86.09 | $108.01 | $185.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.19 / $310.50 / $448.50
| Professional | | $154.19 | $310.50 | $448.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.31 / $122.31 / $227.66
| Facility | | $122.31 | $122.31 | $227.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.29 / $89.29 / $226.88
| Professional | | $89.29 | $89.29 | $226.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.16 / $109.16 / $217.41
| Facility | | $109.16 | $109.16 | $217.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.16 / $216.69 / $217.41
| Professional | | $109.16 | $216.69 | $217.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.00 / $129.59 / $199.57
| Professional | | $103.00 | $129.59 | $199.57 |