- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.23 / $141.88 / $166.92
| Facility | | $119.23 | $141.88 | $166.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.53 / $107.68 / $144.60
| Professional | | $83.53 | $107.68 | $144.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.01 / $546.01 / $546.01
| Facility | | $546.01 | $546.01 | $546.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.50 / $181.45 / $707.60
| Professional | | $99.50 | $181.45 | $707.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.91 / $182.16 / $326.51
| Facility | | $144.91 | $182.16 | $326.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.72 / $192.28 / $282.31
| Professional | | $136.72 | $192.28 | $282.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $135.32 / $393.12
| Professional | | $75.00 | $135.32 | $393.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.48 / $83.79 / $87.46
| Facility | | $76.48 | $83.79 | $87.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.61 / $117.86 / $220.64
| Professional | | $74.61 | $117.86 | $220.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.83 / $238.87 / $339.89
| Professional | | $113.83 | $238.87 | $339.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.00 / $176.54 / $229.00
| Professional | | $145.00 | $176.54 | $229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.01 / $546.01 / $546.01
| Facility | | $546.01 | $546.01 | $546.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.50 / $163.38 / $755.78
| Professional | | $99.50 | $163.38 | $755.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.10 / $56.10 / $56.10
| Professional | | $56.10 | $56.10 | $56.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.48 / $137.87 / $323.64
| Professional | | $86.48 | $137.87 | $323.64 |