- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.44 / $347.44 / $1,344.59
| Facility | | $347.44 | $347.44 | $1,344.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.35 / $367.88 / $459.19
| Professional | | $281.35 | $367.88 | $459.19 |
- 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
- $592.41 / $778.00 / $778.00
| Professional | | $592.41 | $778.00 | $778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.94 / $511.94 / $718.95
| Facility | | $511.94 | $511.94 | $718.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.72 / $373.72 / $959.63
| Professional | | $373.72 | $373.72 | $959.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.43 / $718.95 / $1,366.01
| Professional | | $661.43 | $718.95 | $1,366.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.35 / $525.35 / $525.35
| Professional | | $525.35 | $525.35 | $525.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.44 / $347.44 / $1,344.59
| Facility | | $347.44 | $347.44 | $1,344.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.35 / $370.94 / $558.86
| Professional | | $281.35 | $370.94 | $558.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.90 / $980.50 / $1,416.50
| Professional | | $486.90 | $980.50 | $1,416.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.94 / $511.94 / $718.95
| Facility | | $511.94 | $511.94 | $718.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.72 / $373.72 / $959.63
| Professional | | $373.72 | $373.72 | $959.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.78 / $371.78 / $740.52
| Facility | | $371.78 | $371.78 | $740.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.78 / $740.52 / $755.33
| Professional | | $371.78 | $740.52 | $755.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.50 / $466.80 / $679.76
| Professional | | $353.50 | $466.80 | $679.76 |