- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.15 / $107.35 / $126.29
| Facility | | $87.15 | $107.35 | $126.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.92 / $87.81 / $129.66
| Professional | | $65.92 | $87.81 | $129.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.36 / $409.36 / $409.36
| Facility | | $409.36 | $409.36 | $409.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.75 / $136.78 / $533.79
| Professional | | $74.75 | $136.78 | $533.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.16 / $137.21 / $246.91
| Facility | | $109.16 | $137.21 | $246.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.40 / $150.34 / $217.88
| Professional | | $108.40 | $150.34 | $217.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.00 / $101.00 / $297.06
| Professional | | $46.00 | $101.00 | $297.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.50 / $63.00 / $91.19
| Facility | | $57.50 | $63.00 | $91.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.98 / $87.42 / $155.84
| Professional | | $54.98 | $87.42 | $155.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.39 / $179.60 / $254.41
| Professional | | $86.39 | $179.60 | $254.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.84 / $93.84 / $110.40
| Facility | | $93.84 | $93.84 | $110.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.84 / $123.79 / $164.89
| Professional | | $93.84 | $123.79 | $164.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.36 / $409.36 / $409.36
| Facility | | $409.36 | $409.36 | $409.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.75 / $122.08 / $571.19
| Professional | | $74.75 | $122.08 | $571.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.16 / $77.09 / $170.19
| Professional | | $54.16 | $77.09 | $170.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.90 / $104.52 / $249.03
| Professional | | $60.90 | $104.52 | $249.03 |