- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.13 / $170.16 / $200.19
| Facility | | $150.13 | $170.16 | $200.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.32 / $126.48 / $170.16
| Professional | | $99.32 | $126.48 | $170.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.46 / $651.46 / $651.46
| Facility | | $651.46 | $651.46 | $651.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.71 / $191.27 / $836.19
| Professional | | $108.71 | $191.27 | $836.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.99 / $219.96 / $268.82
| Facility | | $174.99 | $219.96 | $268.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.29 / $201.05 / $335.91
| Professional | | $129.29 | $201.05 | $335.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.00 / $188.42 / $354.55
| Professional | | $106.00 | $188.42 | $354.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.22 / $138.97 / $175.49
| Facility | | $125.22 | $138.97 | $175.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.44 / $131.63 / $175.49
| Professional | | $122.44 | $131.63 | $175.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.72 / $282.64 / $404.26
| Professional | | $135.72 | $282.64 | $404.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.85 / $125.10 / $286.50
| Facility | | $115.85 | $125.10 | $286.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.13 / $125.10 / $161.63
| Professional | | $108.13 | $125.10 | $161.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.46 / $651.46 / $651.46
| Facility | | $651.46 | $651.46 | $651.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.25 / $177.11 / $924.30
| Professional | | $104.25 | $177.11 | $924.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.96 / $103.12 / $194.62
| Facility | | $90.96 | $103.12 | $194.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.96 / $113.43 / $180.00
| Professional | | $90.96 | $113.43 | $180.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.50 / $149.27 / $312.04
| Professional | | $102.50 | $149.27 | $312.04 |