- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.30 / $369.24 / $645.47
| Facility | | $133.30 | $369.24 | $645.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.14 / $133.30 / $164.88
| Professional | | $108.14 | $133.30 | $164.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.36 / $489.37 / $806.84
| Facility | | $185.36 | $489.37 | $806.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.66 / $73.66 / $175.40
| Professional | | $73.66 | $73.66 | $175.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.33 / $117.43 / $535.85
| Facility | | $100.33 | $117.43 | $535.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.53 / $108.59 / $304.93
| Professional | | $81.53 | $108.59 | $304.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.30 / $186.62 / $245.56
| Facility | | $133.30 | $186.62 | $245.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.32 / $249.07 / $455.00
| Professional | | $140.32 | $249.07 | $455.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.33 / $161.33 / $161.33
| Facility | | $161.33 | $161.33 | $161.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.67 / $75.17 / $105.24
| Professional | | $73.67 | $75.17 | $105.24 |