- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.85 / $227.36 / $302.77
| Facility | | $107.85 | $227.36 | $302.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.98 / $107.85 / $127.82
| Professional | | $54.98 | $107.85 | $127.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.33 / $94.92 / $259.87
| Facility | | $61.33 | $94.92 | $259.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.80 / $83.04 / $329.15
| Professional | | $49.80 | $83.04 | $329.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.31 / $181.82 / $329.38
| Facility | | $118.31 | $181.82 | $329.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.36 / $76.36 / $76.36
| Professional | | $76.36 | $76.36 | $76.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.95 / $101.43 / $188.83
| Facility | | $53.95 | $101.43 | $188.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.96 / $79.70 / $216.52
| Professional | | $48.96 | $79.70 | $216.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.95 / $119.95 / $141.12
| Professional | | $119.95 | $119.95 | $141.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.00 / $83.00 / $267.26
| Professional | | $83.00 | $83.00 | $267.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.77 / $81.77 / $81.77
| Facility | | $81.77 | $81.77 | $81.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.41 / $394.25 / $394.25
| Facility | | $144.41 | $394.25 | $394.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.80 / $69.80 / $415.00
| Professional | | $49.80 | $69.80 | $415.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.80 / $53.12 / $148.24
| Professional | | $49.80 | $53.12 | $148.24 |