- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $1,039.50 / $1,452.20
| Facility | | $9.60 | $1,039.50 | $1,452.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $9.60 / $22.60
| Professional | | $9.60 | $9.60 | $22.60 |
- 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
- $64.22 / $66.64 / $66.64
| Professional | | $64.22 | $66.64 | $66.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.83 / $104.83 / $104.83
| Facility | | $104.83 | $104.83 | $104.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.53 / $195.53 / $195.53
| Professional | | $195.53 | $195.53 | $195.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.02 / $162.69 / $341.49
| Facility | | $128.02 | $162.69 | $341.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $967.07 / $1,452.20
| Facility | | $9.60 | $967.07 | $1,452.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $9.60 / $22.86
| Professional | | $9.60 | $9.60 | $22.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.00 / $172.00 / $172.00
| Professional | | $172.00 | $172.00 | $172.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.83 / $104.83 / $104.83
| Facility | | $104.83 | $104.83 | $104.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.53 / $195.53 / $195.53
| Professional | | $195.53 | $195.53 | $195.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.64 / $23.64 / $23.64
| Facility | | $23.64 | $23.64 | $23.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.64 / $23.64 / $23.64
| Professional | | $23.64 | $23.64 | $23.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.58 / $31.58 / $79.29
| Professional | | $31.58 | $31.58 | $79.29 |