- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.88 / $85.68 / $127.85
| Facility | | $50.88 | $85.68 | $127.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.18 / $127.20 / $328.07
| Professional | | $92.18 | $127.20 | $328.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.21 / $120.21 / $120.21
| Professional | | $120.21 | $120.21 | $120.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.67 / $123.14 / $8,639.91
| Facility | | $104.67 | $123.14 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.98 / $116.98 / $116.98
| Professional | | $116.98 | $116.98 | $116.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.07 / $115.07 / $115.07
| Facility | | $115.07 | $115.07 | $115.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.07 / $115.07 / $115.07
| Professional | | $115.07 | $115.07 | $115.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.55 / $60.69 / $138.66
| Facility | | $48.55 | $60.69 | $138.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.21 / $120.21 / $120.21
| Professional | | $120.21 | $120.21 | $120.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.88 / $100.67 / $170.13
| Facility | | $50.88 | $100.67 | $170.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.18 / $124.00 / $337.93
| Professional | | $92.18 | $124.00 | $337.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.07 / $115.07 / $115.07
| Facility | | $115.07 | $115.07 | $115.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.07 / $115.07 / $115.07
| Professional | | $115.07 | $115.07 | $115.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.93 / $94.93 / $94.93
| Facility | | $94.93 | $94.93 | $94.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.93 / $94.93 / $94.93
| Professional | | $94.93 | $94.93 | $94.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.74 / $123.14 / $153.93
| Professional | | $102.74 | $123.14 | $153.93 |