- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.72 / $463.69 / $840.67
| Facility | | $308.72 | $463.69 | $840.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.72 / $308.72 / $839.40
| Professional | | $308.72 | $308.72 | $839.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $25.50 / $30.00
| Professional | | $0.02 | $25.50 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.52 / $515.52 / $515.52
| Facility | | $515.52 | $515.52 | $515.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.84 / $604.84 / $2,235.29
| Professional | | $604.84 | $604.84 | $2,235.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.36 / $329.36 / $329.36
| Professional | | $329.36 | $329.36 | $329.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.52 / $555.00 / $74,999.25
| Facility | | $515.52 | $555.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.84 / $604.84 / $604.84
| Professional | | $604.84 | $604.84 | $604.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.40 / $440.40 / $636.29
| Professional | | $440.40 | $440.40 | $636.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.36 / $336.61 / $336.61
| Facility | | $329.36 | $336.61 | $336.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.36 / $329.36 / $336.61
| Professional | | $329.36 | $329.36 | $336.61 |