- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.17 / $91.17 / $352.83
| Facility | | $91.17 | $91.17 | $352.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.17 / $100.03 / $142.49
| Professional | | $91.17 | $100.03 | $142.49 |
- 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
- $155.44 / $204.15 / $204.15
| Professional | | $155.44 | $204.15 | $204.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.15 / $170.15 / $272.19
| Facility | | $170.15 | $170.15 | $272.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.21 / $124.21 / $238.34
| Professional | | $124.21 | $124.21 | $238.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.41 / $272.19 / $517.16
| Professional | | $250.41 | $272.19 | $517.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.84 / $137.84 / $137.84
| Professional | | $137.84 | $137.84 | $137.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.17 / $91.17 / $352.83
| Facility | | $91.17 | $91.17 | $352.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.04 / $100.11 / $171.60
| Professional | | $85.04 | $100.11 | $171.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.30 / $371.20 / $536.29
| Professional | | $184.30 | $371.20 | $536.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.15 / $170.15 / $272.19
| Facility | | $170.15 | $170.15 | $272.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.21 / $124.21 / $279.38
| Professional | | $124.21 | $124.21 | $279.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.16 / $141.16 / $194.31
| Facility | | $141.16 | $141.16 | $194.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.16 / $194.31 / $259.08
| Professional | | $141.16 | $194.31 | $259.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.87 / $122.76 / $184.10
| Professional | | $95.87 | $122.76 | $184.10 |