- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.76 / $307.30 / $861.21
| Facility | | $115.76 | $307.30 | $861.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.22 / $122.78 / $210.48
| Professional | | $98.22 | $122.78 | $210.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.94 / $526.20 / $919.10
| Facility | | $192.94 | $526.20 | $919.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $96.47 / $175.40
| Professional | | $5.00 | $96.47 | $175.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $175.40 / $175.40
| Facility | | $80.00 | $175.40 | $175.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.83 / $385.35 / $782.10
| Facility | | $116.83 | $385.35 | $782.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.93 / $98.19 / $273.94
| Professional | | $79.93 | $98.19 | $273.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.64 / $833.15 / $833.15
| Facility | | $280.64 | $833.15 | $833.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $877.00 / $877.00 / $1,315.50
| Professional | | $877.00 | $877.00 | $1,315.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.99 / $175.40 / $280.64
| Facility | | $106.99 | $175.40 | $280.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.40 / $175.40 / $219.25
| Professional | | $175.40 | $175.40 | $219.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.01 / $210.48 / $394.65
| Professional | | $114.01 | $210.48 | $394.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.14 / $188.12 / $631.90
| Facility | | $119.14 | $188.12 | $631.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.75 / $157.86 / $266.42
| Professional | | $80.75 | $157.86 | $266.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.67 / $73.67 / $105.24
| Professional | | $73.67 | $73.67 | $105.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.41 / $175.40 / $236.79
| Professional | | $68.41 | $175.40 | $236.79 |