- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.98 / $343.24 / $740.28
| Facility | | $115.98 | $343.24 | $740.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.70 / $122.60 / $167.03
| Professional | | $109.70 | $122.60 | $167.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.95 / $171.36 / $407.46
| Facility | | $110.95 | $171.36 | $407.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.98 / $127.71 / $482.34
| Professional | | $72.98 | $127.71 | $482.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.87 / $341.58 / $640.65
| Facility | | $238.87 | $341.58 | $640.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.68 / $165.68 / $165.68
| Professional | | $165.68 | $165.68 | $165.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.87 / $166.03 / $276.70
| Facility | | $94.87 | $166.03 | $276.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.06 / $128.15 / $316.64
| Professional | | $73.06 | $128.15 | $316.64 |
- 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
- $175.49 / $175.49 / $206.46
| Professional | | $175.49 | $175.49 | $206.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.63 / $121.63 / $395.51
| Professional | | $121.63 | $121.63 | $395.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.50 / $152.58 / $259.55
| Facility | | $125.50 | $152.58 | $259.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.64 / $918.65 / $918.65
| Facility | | $211.64 | $918.65 | $918.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.98 / $99.41 / $608.15
| Professional | | $72.98 | $99.41 | $608.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.98 / $97.30 / $231.95
| Professional | | $72.98 | $97.30 | $231.95 |