- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $213.80 / $616.60
| Facility | | $72.44 | $213.80 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $91.20 / $363.08
| Professional | | $58.88 | $91.20 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $81.28 / $138.04
| Professional | | $52.48 | $81.28 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $891.25 / $1,737.80
| Facility | | $676.08 | $891.25 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $102.33 / $151.36
| Professional | | $63.10 | $102.33 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $87.10
| Facility | | $87.10 | $87.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $154.88 / $229.09
| Professional | | $85.11 | $154.88 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $123.03 / $331.13
| Facility | | $67.61 | $123.03 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $151.36 / $602.56
| Professional | | $89.13 | $151.36 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $177.83 / $229.09
| Professional | | $128.82 | $177.83 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $87.10
| Facility | | $87.10 | $87.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $177.83 / $245.47
| Professional | | $128.82 | $177.83 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,230.27 / $4,466.84
| Facility | | $346.74 | $1,230.27 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $120.23 / $186.21
| Professional | | $69.18 | $120.23 | $186.21 |