- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.96 / $236.90 / $257.47
| Facility | | $181.96 | $236.90 | $257.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.99 / $236.90 / $267.83
| Professional | | $52.99 | $236.90 | $267.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.92 / $90.56 / $266.13
| Professional | | $72.92 | $90.56 | $266.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.47 / $131.47 / $131.47
| Facility | | $131.47 | $131.47 | $131.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.47 / $131.47 / $131.47
| Professional | | $131.47 | $131.47 | $131.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.56 / $308.04 / $2,106.03
| Facility | | $239.56 | $308.04 | $2,106.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.84 / $413.17 / $700.59
| Professional | | $82.84 | $413.17 | $700.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.22 / $229.00 / $396.17
| Facility | | $80.22 | $229.00 | $396.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.20 / $97.87 / $234.00
| Professional | | $72.20 | $97.87 | $234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.14 / $151.40 / $229.90
| Professional | | $81.14 | $151.40 | $229.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.07 / $308.04 / $1,983.08
| Facility | | $233.07 | $308.04 | $1,983.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.23 / $78.23 / $575.55
| Professional | | $78.23 | $78.23 | $575.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.28 / $103.55 / $298.48
| Professional | | $80.28 | $103.55 | $298.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.33 / $92.33 / $261.04
| Facility | | $92.33 | $92.33 | $261.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.14 / $126.90 / $233.37
| Professional | | $81.14 | $126.90 | $233.37 |