- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $316.23 / $537.03
| Facility | | $128.82 | $316.23 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $144.54 / $562.34
| Professional | | $97.72 | $144.54 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $316.23 / $741.31
| Facility | | $125.89 | $316.23 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $186.21 / $741.31
| Professional | | $95.50 | $186.21 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $109.65 / $177.83
| Facility | | $70.79 | $109.65 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $223.87 / $457.09
| Facility | | $89.13 | $223.87 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $194.98 / $416.87
| Professional | | $107.15 | $194.98 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $181.97 / $7,079.46
| Facility | | $83.18 | $181.97 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $144.54 / $251.19
| Professional | | $45.71 | $144.54 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $213.80 / $346.74
| Professional | | $134.90 | $213.80 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $223.87 / $354.81
| Facility | | $204.17 | $223.87 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $64.57 / $213.80
| Professional | | $48.98 | $64.57 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $316.23 / $741.31
| Facility | | $125.89 | $316.23 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $186.21 / $741.31
| Professional | | $95.50 | $186.21 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $123.03 / $251.19
| Facility | | $57.54 | $123.03 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $181.97 / $363.08
| Professional | | $100.00 | $181.97 | $363.08 |