- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.23 / $345.76 / $469.33
| Facility | | $105.23 | $345.76 | $469.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.84 / $105.23 / $135.30
| Professional | | $98.84 | $105.23 | $135.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.08 / $171.92 / $470.68
| Facility | | $111.08 | $171.92 | $470.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.20 / $150.33 / $596.15
| Professional | | $90.20 | $150.33 | $596.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.33 / $214.97 / $403.19
| Facility | | $150.33 | $214.97 | $403.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.31 / $141.31 / $141.31
| Professional | | $141.31 | $141.31 | $141.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.75 / $107.48 / $341.99
| Facility | | $93.75 | $107.48 | $341.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.78 / $144.44 / $293.47
| Professional | | $79.78 | $144.44 | $293.47 |
- 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
- $217.04 / $217.04 / $255.34
| Professional | | $217.04 | $217.04 | $255.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.33 / $150.33 / $335.24
| Professional | | $150.33 | $150.33 | $335.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.11 / $159.30 / $188.59
| Facility | | $148.11 | $159.30 | $188.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.57 / $883.04 / $883.04
| Facility | | $261.57 | $883.04 | $883.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.20 / $90.20 / $748.64
| Professional | | $90.20 | $90.20 | $748.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.20 / $90.20 / $310.70
| Professional | | $90.20 | $90.20 | $310.70 |