- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $251.19 / $416.87
| Facility | | $81.28 | $251.19 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $114.82 / $389.05
| Professional | | $81.28 | $114.82 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $269.15 / $676.08
| Facility | | $120.23 | $269.15 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $138.04 / $1,862.09
| Professional | | $85.11 | $138.04 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $218.78 / $549.54
| Facility | | $177.83 | $218.78 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $218.78 / $331.13
| Professional | | $125.89 | $218.78 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $354.81 / $512.86
| Facility | | $131.83 | $354.81 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $204.17 / $316.23
| Professional | | $123.03 | $204.17 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $181.97 / $7,079.46
| Facility | | $109.65 | $181.97 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $158.49 / $234.42
| Professional | | $128.82 | $158.49 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $151.36 / $288.40
| Professional | | $109.65 | $151.36 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $269.15 / $676.08
| Facility | | $120.23 | $269.15 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $138.04 / $1,862.09
| Professional | | $85.11 | $138.04 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $144.54 / $302.00
| Professional | | $109.65 | $144.54 | $302.00 |