- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $77.62 / $309.03
| Facility | | $75.86 | $77.62 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $77.62 / $316.23
| Professional | | $52.48 | $77.62 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $239.88 / $1,230.27
| Facility | | $81.28 | $239.88 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $97.72 / $467.74
| Professional | | $56.23 | $97.72 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $724.44
| Facility | | $407.38 | $501.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $707.95 / $2,630.27
| Facility | | $208.93 | $707.95 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $131.83 / $234.42
| Professional | | $91.20 | $131.83 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $117.49 / $7,079.46
| Facility | | $67.61 | $117.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $93.33 / $147.91
| Professional | | $12.02 | $93.33 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $102.33 / $229.09
| Professional | | $74.13 | $102.33 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $239.88 / $1,230.27
| Facility | | $81.28 | $239.88 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $97.72 / $467.74
| Professional | | $56.23 | $97.72 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $630.96 / $1,318.26
| Facility | | $67.61 | $630.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $117.49 / $309.03
| Professional | | $77.62 | $117.49 | $309.03 |