- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.45 / $379.52 / $892.01
| Facility | | $116.45 | $379.52 | $892.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.05 / $116.45 / $880.91
| Professional | | $89.05 | $116.45 | $880.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.84 / $297.69 / $686.37
| Facility | | $146.84 | $297.69 | $686.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.80 / $128.37 / $314.33
| Professional | | $54.80 | $128.37 | $314.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.60 / $206.87 / $376.75
| Facility | | $96.60 | $206.87 | $376.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.34 / $89.05 / $223.86
| Professional | | $62.34 | $89.05 | $223.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.13 / $229.75 / $458.61
| Facility | | $93.13 | $229.75 | $458.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.17 / $111.10 / $556.86
| Professional | | $70.17 | $111.10 | $556.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.60 / $137.00 / $184.95
| Professional | | $109.60 | $137.00 | $184.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.30 / $157.55 / $310.47
| Professional | | $123.30 | $157.55 | $310.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.38 / $650.75 / $650.75
| Facility | | $238.38 | $650.75 | $650.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.00 / $685.00 / $1,027.50
| Professional | | $685.00 | $685.00 | $1,027.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.60 / $164.40 / $392.98
| Facility | | $109.60 | $164.40 | $392.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.58 / $157.55 / $370.31
| Professional | | $73.58 | $157.55 | $370.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.87 / $480.87 / $480.87
| Professional | | $480.87 | $480.87 | $480.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.60 / $123.30 / $186.32
| Professional | | $109.60 | $123.30 | $186.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $57.54 / $302.50
| Professional | | $57.54 | $57.54 | $302.50 |