- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.22 / $161.63 / $314.77
| Facility | | $95.22 | $161.63 | $314.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.65 / $90.74 / $97.46
| Professional | | $80.65 | $90.74 | $97.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.50 / $100.00 / $315.89
| Facility | | $80.50 | $100.00 | $315.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.06 / $156.82 / $198.27
| Facility | | $131.06 | $156.82 | $198.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.40 / $204.77 / $436.88
| Facility | | $36.40 | $204.77 | $436.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.62 / $67.20 / $132.72
| Professional | | $63.62 | $67.20 | $132.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.97 / $72.81 / $107.34
| Professional | | $50.97 | $72.81 | $107.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.91 / $7.67 / $82.22
| Professional | | $6.91 | $7.67 | $82.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.02 / $112.02 / $112.02
| Professional | | $112.02 | $112.02 | $112.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.22 / $112.02 / $112.02
| Professional | | $95.22 | $112.02 | $112.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.98 / $165.43 / $336.02
| Facility | | $74.98 | $165.43 | $336.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.44 / $128.44 / $160.55
| Professional | | $128.44 | $128.44 | $160.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.02 / $112.02 / $168.03
| Facility | | $112.02 | $112.02 | $168.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.05 / $67.20 / $134.41
| Professional | | $47.05 | $67.20 | $134.41 |