- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.00 / $334.62 / $511.14
| Facility | | $99.00 | $334.62 | $511.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.44 / $99.00 / $785.88
| Professional | | $90.44 | $99.00 | $785.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.16 / $694.47 / $8,459.92
| Facility | | $521.16 | $694.47 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.33 / $95.33 / $95.33
| Professional | | $95.33 | $95.33 | $95.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.98 / $180.43 / $405.30
| Facility | | $115.98 | $180.43 | $405.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.42 / $117.40 / $261.95
| Professional | | $64.42 | $117.40 | $261.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.72 / $165.00 / $232.22
| Professional | | $72.72 | $165.00 | $232.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.42 / $217.42 / $217.42
| Facility | | $217.42 | $217.42 | $217.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.89 / $334.62 / $504.77
| Facility | | $103.89 | $334.62 | $504.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.44 / $103.89 / $504.77
| Professional | | $90.44 | $103.89 | $504.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.89 / $183.33 / $244.44
| Professional | | $180.89 | $183.33 | $244.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.01 / $203.33 / $405.30
| Facility | | $119.01 | $203.33 | $405.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.08 / $128.91 / $262.95
| Professional | | $65.08 | $128.91 | $262.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $165.98
| Facility | | $122.22 | $122.22 | $165.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $165.98
| Professional | | $122.22 | $122.22 | $165.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.33 / $73.33 / $223.66
| Professional | | $51.33 | $73.33 | $223.66 |