- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.33 / $251.08 / $455.29
| Facility | | $87.33 | $251.08 | $455.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.55 / $87.33 / $156.85
| Professional | | $57.55 | $87.33 | $156.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.62 / $129.15 / $307.06
| Facility | | $83.62 | $129.15 | $307.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $96.24 / $363.49
| Professional | | $55.00 | $96.24 | $363.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.87 / $257.20 / $449.68
| Facility | | $179.87 | $257.20 | $449.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.27 / $117.27 / $117.27
| Professional | | $117.27 | $117.27 | $117.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.50 / $125.12 / $208.53
| Facility | | $71.50 | $125.12 | $208.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.90 / $91.76 / $239.07
| Professional | | $54.90 | $91.76 | $239.07 |
- 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
- $132.08 / $132.08 / $155.38
| Professional | | $132.08 | $132.08 | $155.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.66 / $91.66 / $298.05
| Professional | | $91.66 | $91.66 | $298.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.97 / $121.17 / $256.13
| Facility | | $96.97 | $121.17 | $256.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.49 / $435.39 / $435.39
| Facility | | $159.49 | $435.39 | $435.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $75.04 / $458.30
| Professional | | $55.00 | $75.04 | $458.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $75.04 / $187.59
| Professional | | $55.00 | $75.04 | $187.59 |