- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $162.18 / $407.38
| Facility | | $64.57 | $162.18 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $61.66 / $302.00
| Professional | | $52.48 | $61.66 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $95.50 / $323.59
| Facility | | $61.66 | $95.50 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $67.61 / $141.25
| Professional | | $40.74 | $67.61 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $165.96 / $263.03
| Facility | | $131.83 | $165.96 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $87.10
| Professional | | $63.10 | $63.10 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $107.15 / $263.03
| Facility | | $52.48 | $107.15 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $81.28 / $117.49
| Professional | | $48.98 | $81.28 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $9,772.37
| Facility | | $56.23 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $114.82
| Professional | | $97.72 | $97.72 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $67.61 / $204.17
| Professional | | $67.61 | $67.61 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $87.10 / $229.09
| Facility | | $79.43 | $87.10 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $95.50 / $323.59
| Facility | | $61.66 | $95.50 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $67.61 / $141.25
| Professional | | $40.74 | $67.61 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $81.28 / $109.65
| Facility | | $58.88 | $81.28 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $69.18 / $100.00
| Professional | | $58.88 | $69.18 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $67.61 / $109.65
| Facility | | $38.90 | $67.61 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $58.88 / $162.18
| Professional | | $33.11 | $58.88 | $162.18 |