- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.76 / $279.91 / $455.86
| Facility | | $130.76 | $279.91 | $455.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.17 / $87.17 / $135.96
| Professional | | $87.17 | $87.17 | $135.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $9.64 / $110.36
| Professional | | $9.64 | $9.64 | $110.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.94 / $337.90 / $558.66
| Facility | | $191.94 | $337.90 | $558.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.79 / $229.73 / $770.96
| Professional | | $183.79 | $229.73 | $770.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.94 / $282.00 / $359.89
| Facility | | $159.94 | $282.00 | $359.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.98 / $94.37 / $299.11
| Professional | | $63.98 | $94.37 | $299.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.18 / $151.94 / $179.64
| Professional | | $100.18 | $151.94 | $179.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.94 / $339.25 / $597.00
| Facility | | $191.94 | $339.25 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.97 / $159.94 / $329.50
| Professional | | $103.97 | $159.94 | $329.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.97 / $103.97 / $103.97
| Facility | | $103.97 | $103.97 | $103.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.18 / $91.78 / $239.93
| Professional | | $67.18 | $91.78 | $239.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.34 / $183.94 / $183.94
| Facility | | $163.34 | $183.94 | $183.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.18 / $151.94 / $192.25
| Professional | | $100.18 | $151.94 | $192.25 |