- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.47 / $174.28 / $256.13
| Professional | | $149.47 | $174.28 | $256.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.87 / $87.87 / $87.87
| Professional | | $87.87 | $87.87 | $87.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.47 / $256.13 / $307.36
| Facility | | $147.47 | $256.13 | $307.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.91 / $255.65 / $269.10
| Professional | | $173.91 | $255.65 | $269.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Professional | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.47 / $256.13 / $307.36
| Facility | | $147.47 | $256.13 | $307.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.87 / $214.52 / $10,000.00
| Professional | | $87.87 | $214.52 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.50 / $134.25 / $441.78
| Professional | | $79.50 | $134.25 | $441.78 |