- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.23 / $78.30 / $246.96
| Facility | | $70.23 | $78.30 | $246.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.29 / $77.26 / $136.86
| Professional | | $68.29 | $77.26 | $136.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.02 / $66.80 / $91.33
| Professional | | $58.02 | $66.80 | $91.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.33 / $88.33 / $399.75
| Facility | | $88.33 | $88.33 | $399.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.02 / $95.33 / $189.65
| Professional | | $72.02 | $95.33 | $189.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $148.50 / $950.89
| Facility | | $92.60 | $148.50 | $950.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.22 / $90.32 / $186.75
| Professional | | $63.22 | $90.32 | $186.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.63 / $800.00 / $1,734.00
| Facility | | $157.63 | $800.00 | $1,734.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.19 / $90.68 / $189.66
| Professional | | $70.19 | $90.68 | $189.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.60 / $78.02 / $105.33
| Professional | | $56.60 | $78.02 | $105.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.31 / $79.91 / $134.00
| Professional | | $64.31 | $79.91 | $134.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.07 / $958.63 / $958.63
| Facility | | $165.07 | $958.63 | $958.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $792.53 / $848.55 / $848.55
| Professional | | $792.53 | $848.55 | $848.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.23 / $90.34 / $189.00
| Facility | | $70.23 | $90.34 | $189.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.26 / $101.73 / $188.88
| Professional | | $72.26 | $101.73 | $188.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.62 / $237.62 / $237.62
| Professional | | $237.62 | $237.62 | $237.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.60 / $71.78 / $102.96
| Professional | | $56.60 | $71.78 | $102.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $420.00 / $840.00
| Facility | | $300.00 | $420.00 | $840.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.35 / $73.78 / $149.61
| Professional | | $55.35 | $73.78 | $149.61 |