- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.55 / $325.86 / $533.38
| Facility | | $119.55 | $325.86 | $533.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.05 / $119.55 / $163.94
| Professional | | $90.05 | $119.55 | $163.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.48 / $218.37 / $596.13
| Facility | | $114.48 | $218.37 | $596.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.50 / $125.50 / $305.69
| Professional | | $73.50 | $125.50 | $305.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.20 / $352.24 / $615.79
| Facility | | $221.20 | $352.24 | $615.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.97 / $117.97 / $160.53
| Professional | | $117.97 | $117.97 | $160.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.70 / $184.62 / $424.73
| Facility | | $87.70 | $184.62 | $424.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.90 / $138.75 / $211.07
| Professional | | $73.90 | $138.75 | $211.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.10 / $181.10 / $213.06
| Professional | | $181.10 | $181.10 | $213.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.50 / $173.94 / $467.12
| Professional | | $125.50 | $173.94 | $467.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.30 / $269.30 / $274.69
| Facility | | $269.30 | $269.30 | $274.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.37 / $596.13 / $596.13
| Facility | | $218.37 | $596.13 | $596.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.24 / $75.30 / $264.89
| Professional | | $60.24 | $75.30 | $264.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.21 / $75.30 / $497.69
| Professional | | $62.21 | $75.30 | $497.69 |