- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $257.04 / $426.58
| Facility | | $87.10 | $257.04 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $51.29 / $61.66
| Professional | | $40.74 | $51.29 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $309.03 / $316.23
| Facility | | $154.88 | $309.03 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $36.31 / $60.26
| Professional | | $31.62 | $36.31 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $144.54 / $602.56
| Facility | | $60.26 | $144.54 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $46.77 / $114.82
| Professional | | $36.31 | $46.77 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.69 / $81.28 / $208.93
| Facility | | $41.69 | $81.28 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $75.86 / $95.50
| Professional | | $54.95 | $75.86 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $100.00
| Professional | | $61.66 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $61.66 / $109.65
| Professional | | $50.12 | $61.66 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $19.95 / $30.90
| Professional | | $19.95 | $19.95 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $69.18 / $158.49
| Facility | | $32.36 | $69.18 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $61.66 / $74.13
| Professional | | $44.67 | $61.66 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $63.10 / $104.71
| Professional | | $50.12 | $63.10 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $33.88 / $61.66
| Facility | | $26.30 | $33.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $28.18 / $109.65
| Professional | | $26.30 | $28.18 | $109.65 |