- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.05 / $387.91 / $564.70
| Facility | | $110.05 | $387.91 | $564.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.57 / $115.48 / $186.57
| Professional | | $51.57 | $115.48 | $186.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.06 / $436.40 / $8,639.91
| Facility | | $336.06 | $436.40 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.97 / $105.97 / $105.97
| Professional | | $105.97 | $105.97 | $105.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.29 / $180.92 / $450.94
| Facility | | $89.29 | $180.92 | $450.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.27 / $156.11 / $238.23
| Professional | | $85.27 | $156.11 | $238.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.50 / $80.16 / $183.95
| Professional | | $62.50 | $80.16 | $183.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.00 / $230.17 / $605.99
| Facility | | $179.00 | $230.17 | $605.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.50 / $130.50 / $130.50
| Professional | | $130.50 | $130.50 | $130.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.05 / $385.18 / $564.70
| Facility | | $110.05 | $385.18 | $564.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.59 / $120.00 / $561.10
| Professional | | $85.59 | $120.00 | $561.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.96 / $206.38 / $450.94
| Facility | | $90.96 | $206.38 | $450.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.27 / $156.11 / $238.23
| Professional | | $85.27 | $156.11 | $238.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.86 / $135.86 / $173.68
| Facility | | $135.86 | $135.86 | $173.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.56 / $135.86 / $173.68
| Professional | | $119.56 | $135.86 | $173.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.79 / $81.52 / $214.33
| Professional | | $43.79 | $81.52 | $214.33 |