- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $93.33 / $263.03
| Facility | | $63.10 | $93.33 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $95.50 / $190.55
| Professional | | $63.10 | $95.50 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $123.03 / $316.23
| Professional | | $74.13 | $123.03 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $181.97
| Facility | | $79.43 | $79.43 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $138.04 / $239.88
| Professional | | $74.13 | $138.04 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $128.82 / $7,079.46
| Facility | | $61.66 | $128.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $154.88 / $194.98
| Professional | | $125.89 | $154.88 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $134.90 / $281.84
| Professional | | $72.44 | $134.90 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $123.03 / $316.23
| Professional | | $74.13 | $123.03 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $131.83 / $275.42
| Professional | | $74.13 | $131.83 | $275.42 |