- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.35 / $249.23 / $438.90
| Facility | | $109.35 | $249.23 | $438.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.08 / $94.05 / $133.24
| Professional | | $83.08 | $94.05 | $133.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.28 / $13.28 / $120.38
| Professional | | $13.28 | $13.28 | $120.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.89 / $220.08 / $548.01
| Facility | | $101.89 | $220.08 | $548.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.31 / $755.54 / $1,875.37
| Professional | | $191.31 | $755.54 | $1,875.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.75 / $282.14 / $352.69
| Facility | | $156.75 | $282.14 | $352.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.59 / $206.91 / $340.15
| Professional | | $164.59 | $206.91 | $340.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.24 / $156.75 / $284.23
| Professional | | $133.24 | $156.75 | $284.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.89 / $331.14 / $597.00
| Facility | | $101.89 | $331.14 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.89 / $188.10 / $379.34
| Professional | | $101.89 | $188.10 | $379.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.08 / $141.08 / $156.75
| Facility | | $141.08 | $141.08 | $156.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.84 / $94.05 / $235.13
| Professional | | $65.84 | $94.05 | $235.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.75 / $180.26 / $180.26
| Facility | | $156.75 | $180.26 | $180.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.24 / $156.75 / $188.40
| Professional | | $133.24 | $156.75 | $188.40 |