- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.90 / $337.00 / $935.68
| Facility | | $144.90 | $337.00 | $935.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.17 / $130.49 / $219.65
| Professional | | $72.17 | $130.49 | $219.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.02 / $180.74 / $436.73
| Facility | | $117.02 | $180.74 | $436.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.48 / $142.63 / $565.62
| Professional | | $62.48 | $142.63 | $565.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.47 / $359.60 / $628.67
| Facility | | $251.47 | $359.60 | $628.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.91 / $134.07 / $141.19
| Professional | | $96.91 | $134.07 | $141.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.95 / $255.58 / $495.27
| Facility | | $102.95 | $255.58 | $495.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.60 / $150.41 / $371.69
| Professional | | $85.60 | $150.41 | $371.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.34 / $285.26 / $6,679.00
| Facility | | $109.34 | $285.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.61 / $199.68 / $303.80
| Professional | | $157.61 | $199.68 | $303.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $142.63 / $441.71
| Professional | | $142.63 | $142.63 | $441.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.19 / $163.15 / $319.60
| Facility | | $137.19 | $163.15 | $319.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.18 / $677.49 / $677.49
| Facility | | $248.18 | $677.49 | $677.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.48 / $85.58 / $713.15
| Professional | | $62.48 | $85.58 | $713.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.48 / $85.58 / $254.75
| Professional | | $62.48 | $85.58 | $254.75 |