- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.09 / $99.55 / $288.05
| Facility | | $88.09 | $99.55 | $288.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.28 / $88.09 / $124.61
| Professional | | $72.28 | $88.09 | $124.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.41 / $8,459.92 / $79,506.39
| Facility | | $64.41 | $8,459.92 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.05 / $111.09 / $189.49
| Professional | | $107.05 | $111.09 | $189.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.33 / $186.33 / $186.33
| Facility | | $186.33 | $186.33 | $186.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.84 / $118.66 / $178.70
| Professional | | $69.84 | $118.66 | $178.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.60 / $164.30 / $165.03
| Professional | | $93.60 | $164.30 | $165.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.80 / $306.80 / $461.08
| Facility | | $306.80 | $306.80 | $461.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.09 / $164.73 / $347.96
| Facility | | $88.09 | $164.73 | $347.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.58 / $92.57 / $261.62
| Professional | | $76.58 | $92.57 | $261.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.10 / $120.10 / $164.60
| Professional | | $120.10 | $120.10 | $164.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.33 / $186.33 / $186.33
| Facility | | $186.33 | $186.33 | $186.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.63 / $118.66 / $197.18
| Professional | | $81.63 | $118.66 | $197.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.00 / $102.05 / $102.05
| Facility | | $101.00 | $102.05 | $102.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.57 / $102.05 / $107.17
| Professional | | $95.57 | $102.05 | $107.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.40 / $111.35 / $199.39
| Professional | | $80.40 | $111.35 | $199.39 |