- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.77 / $111.44 / $190.58
| Facility | | $99.77 | $111.44 | $190.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.89 / $94.22 / $300.94
| Professional | | $83.89 | $94.22 | $300.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.77 / $251.25 / $539.87
| Facility | | $114.77 | $251.25 | $539.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.38 / $153.32 / $652.77
| Professional | | $87.38 | $153.32 | $652.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.09 / $107.79 / $213.79
| Facility | | $78.09 | $107.79 | $213.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.62 / $242.60 / $390.51
| Facility | | $89.62 | $242.60 | $390.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.52 / $171.30 / $324.66
| Professional | | $96.52 | $171.30 | $324.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.75 / $161.63 / $6,679.00
| Facility | | $73.75 | $161.63 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.78 / $103.05 / $185.73
| Professional | | $37.78 | $103.05 | $185.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.65 / $230.17 / $310.08
| Professional | | $121.65 | $230.17 | $310.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.08 / $537.60 / $693.60
| Facility | | $258.08 | $537.60 | $693.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.42 / $84.50 / $91.92
| Professional | | $49.42 | $84.50 | $91.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.58 / $539.87 / $539.87
| Facility | | $211.58 | $539.87 | $539.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.41 / $149.26 / $652.77
| Professional | | $90.41 | $149.26 | $652.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.38 / $134.94 / $256.20
| Professional | | $87.38 | $134.94 | $256.20 |