- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.31 / $254.00 / $322.27
| Facility | | $72.31 | $254.00 | $322.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.46 / $73.65 / $429.00
| Professional | | $55.46 | $73.65 | $429.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.31 / $398.85 / $8,459.92
| Facility | | $299.31 | $398.85 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.76 / $54.76 / $54.76
| Professional | | $54.76 | $54.76 | $54.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.62 / $103.51 / $232.53
| Facility | | $66.62 | $103.51 | $232.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.96 / $67.36 / $129.41
| Professional | | $39.96 | $67.36 | $129.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.77 / $94.77 / $133.38
| Professional | | $41.77 | $94.77 | $133.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.86 / $186.74 / $356.98
| Facility | | $118.86 | $186.74 | $356.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.64 / $209.88 / $314.14
| Facility | | $65.64 | $209.88 | $314.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.86 / $81.90 / $395.20
| Professional | | $56.86 | $81.90 | $395.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.31 / $116.79 / $232.53
| Facility | | $68.31 | $116.79 | $232.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.08 / $71.01 / $150.66
| Professional | | $40.08 | $71.01 | $150.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.33 / $95.33 / $95.33
| Facility | | $95.33 | $95.33 | $95.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.33 / $95.33 / $95.33
| Professional | | $95.33 | $95.33 | $95.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.48 / $42.12 / $105.30
| Professional | | $29.48 | $42.12 | $105.30 |