- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.00 / $332.34 / $511.14
| Facility | | $99.00 | $332.34 | $511.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.74 / $100.22 / $308.55
| Professional | | $94.74 | $100.22 | $308.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.90 / $767.42 / $8,459.92
| Facility | | $575.90 | $767.42 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.33 / $95.33 / $95.33
| Professional | | $95.33 | $95.33 | $95.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.98 / $180.43 / $405.30
| Facility | | $115.98 | $180.43 | $405.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.38 / $130.74 / $276.24
| Professional | | $64.38 | $130.74 | $276.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.72 / $165.00 / $232.22
| Professional | | $72.72 | $165.00 | $232.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.03 / $344.11 / $747.25
| Facility | | $161.03 | $344.11 | $747.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.89 / $332.34 / $540.39
| Facility | | $103.89 | $332.34 | $540.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.74 / $148.50 / $504.77
| Professional | | $94.74 | $148.50 | $504.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.89 / $183.33 / $244.44
| Professional | | $180.89 | $183.33 | $244.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.01 / $203.33 / $405.30
| Facility | | $119.01 | $203.33 | $405.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.29 / $141.18 / $276.24
| Professional | | $72.29 | $141.18 | $276.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $184.80
| Facility | | $122.22 | $122.22 | $184.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $184.80
| Professional | | $122.22 | $122.22 | $184.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.33 / $73.33 / $183.33
| Professional | | $51.33 | $73.33 | $183.33 |