- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $245.47 / $416.87
| Facility | | $138.04 | $245.47 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $114.82 / $223.87
| Professional | | $81.28 | $114.82 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $354.81
| Facility | | $138.04 | $138.04 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $263.03
| Professional | | $54.95 | $54.95 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $138.04 / $138.04
| Facility | | $81.28 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $138.04 / $138.04
| Professional | | $100.00 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $295.12 / $354.81
| Facility | | $89.13 | $295.12 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $169.82 / $660.69
| Professional | | $83.18 | $169.82 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $173.78 / $380.19
| Facility | | $107.15 | $173.78 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $134.90 / $245.47
| Professional | | $95.50 | $134.90 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $134.90 / $245.47
| Professional | | $109.65 | $134.90 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $257.04 / $50,118.72
| Facility | | $177.83 | $257.04 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $141.25
| Professional | | $138.04 | $138.04 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $138.04 / $165.96
| Facility | | $123.03 | $138.04 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $81.28 / $181.97
| Professional | | $57.54 | $81.28 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $144.54 / $169.82
| Facility | | $112.20 | $144.54 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $138.04 / $269.15
| Professional | | $112.20 | $138.04 | $269.15 |