- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.95 / $1,086.11 / $1,458.35
| Facility | | $60.95 | $1,086.11 | $1,458.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.22 / $172.76 / $218.67
| Professional | | $151.22 | $172.76 | $218.67 |
- 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
- $279.79 / $367.44 / $367.44
| Professional | | $279.79 | $367.44 | $367.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.27 / $274.27 / $402.29
| Facility | | $274.27 | $274.27 | $402.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.13 / $233.13 / $352.25
| Professional | | $233.13 | $233.13 | $352.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.11 / $402.29 / $764.35
| Professional | | $370.11 | $402.29 | $764.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.47 / $464.41 / $1,599.19
| Facility | | $28.47 | $464.41 | $1,599.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.95 / $808.40 / $1,458.35
| Facility | | $60.95 | $808.40 | $1,458.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.83 / $173.75 / $253.62
| Professional | | $147.83 | $173.75 | $253.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.39 / $548.70 / $792.60
| Professional | | $272.39 | $548.70 | $792.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.27 / $274.27 / $402.29
| Facility | | $274.27 | $274.27 | $402.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.13 / $233.13 / $475.50
| Professional | | $233.13 | $233.13 | $475.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.10 / $254.10 / $349.74
| Facility | | $254.10 | $254.10 | $349.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.10 / $349.74 / $382.90
| Professional | | $254.10 | $349.74 | $382.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.68 / $203.46 / $321.05
| Professional | | $165.68 | $203.46 | $321.05 |