- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.22 / $127.59 / $210.88
| Facility | | $100.22 | $127.59 | $210.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.95 / $104.71 / $137.30
| Professional | | $80.95 | $104.71 | $137.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.64 / $102.34 / $184.70
| Professional | | $91.64 | $102.34 | $184.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.63 / $153.12 / $212.50
| Professional | | $127.63 | $153.12 | $212.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.15 / $187.15 / $187.15
| Facility | | $187.15 | $187.15 | $187.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.32 / $125.85 / $225.69
| Professional | | $86.32 | $125.85 | $225.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.67 / $168.99 / $187.56
| Professional | | $124.67 | $168.99 | $187.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.57 / $131.59 / $152.38
| Professional | | $118.57 | $131.59 | $152.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.45 / $130.00 / $239.01
| Facility | | $108.45 | $130.00 | $239.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.50 / $115.08 / $176.77
| Professional | | $86.50 | $115.08 | $176.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.75 / $120.38 / $144.38
| Professional | | $70.75 | $120.38 | $144.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.75 / $116.57 / $143.50
| Professional | | $70.75 | $116.57 | $143.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.15 / $187.15 / $187.15
| Facility | | $187.15 | $187.15 | $187.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.00 / $124.43 / $250.83
| Professional | | $81.00 | $124.43 | $250.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.58 / $100.15 / $114.34
| Facility | | $99.58 | $100.15 | $114.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.15 / $105.84 / $145.80
| Professional | | $100.15 | $105.84 | $145.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.63 / $123.38 / $220.35
| Professional | | $91.63 | $123.38 | $220.35 |