- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.30 / $181.70 / $240.76
| Facility | | $55.30 | $181.70 | $240.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.94 / $55.30 / $63.99
| Professional | | $51.94 | $55.30 | $63.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.46 / $375.25 / $375.25
| Facility | | $137.46 | $375.25 | $375.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.40 / $47.40 / $395.00
| Professional | | $47.40 | $47.40 | $395.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.00 / $112.97 / $197.50
| Facility | | $79.00 | $112.97 | $197.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.26 / $74.26 / $74.26
| Professional | | $74.26 | $74.26 | $74.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.86 / $61.62 / $179.73
| Facility | | $51.86 | $61.62 | $179.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.45 / $87.45 / $104.78
| Professional | | $87.45 | $87.45 | $104.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.89 / $113.89 / $133.97
| Professional | | $113.89 | $113.89 | $133.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.00 / $79.00 / $164.07
| Professional | | $79.00 | $79.00 | $164.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.46 / $375.25 / $375.25
| Facility | | $137.46 | $375.25 | $375.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.40 / $47.40 / $395.00
| Professional | | $47.40 | $47.40 | $395.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.40 / $47.40 / $296.64
| Professional | | $47.40 | $47.40 | $296.64 |