- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.38 / $152.91 / $591.76
| Facility | | $140.38 | $152.91 | $591.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.97 / $145.58 / $242.28
| Professional | | $129.97 | $145.58 | $242.28 |
- 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
- $393.46 / $518.13 / $518.13
| Professional | | $393.46 | $518.13 | $518.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.07 / $409.07 / $409.07
| Facility | | $409.07 | $409.07 | $409.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.71 / $347.71 / $421.34
| Professional | | $347.71 | $347.71 | $421.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.79 / $484.55 / $920.65
| Professional | | $445.79 | $484.55 | $920.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.50 / $262.50 / $262.50
| Professional | | $262.50 | $262.50 | $262.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.91 / $152.91 / $591.76
| Facility | | $152.91 | $152.91 | $591.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.97 / $145.58 / $242.28
| Professional | | $129.97 | $145.58 | $242.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.30 / $234.40 / $882.70
| Professional | | $195.30 | $234.40 | $882.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.07 / $409.07 / $409.07
| Facility | | $409.07 | $409.07 | $409.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.71 / $347.71 / $607.88
| Professional | | $347.71 | $347.71 | $607.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.62 / $442.62 / $442.62
| Facility | | $442.62 | $442.62 | $442.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.62 / $442.62 / $442.62
| Professional | | $442.62 | $442.62 | $442.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.88 / $318.88 / $318.88
| Facility | | $318.88 | $318.88 | $318.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.78 / $270.52 / $444.63
| Professional | | $159.78 | $270.52 | $444.63 |