- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.38 / $158.03 / $378.94
| Facility | | $69.38 | $158.03 | $378.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.56 / $83.65 / $181.02
| Professional | | $57.56 | $83.65 | $181.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.96 / $233.52 / $566.91
| Facility | | $87.96 | $233.52 | $566.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.96 / $146.96 / $309.81
| Professional | | $87.96 | $146.96 | $309.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.04 / $185.07 / $242.54
| Facility | | $130.04 | $185.07 | $242.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.49 / $131.49 / $131.49
| Professional | | $131.49 | $131.49 | $131.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.00 / $115.00 / $145.00
| Facility | | $90.00 | $115.00 | $145.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.52 / $170.35 / $327.95
| Professional | | $97.52 | $170.35 | $327.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.07 / $168.39 / $6,679.00
| Facility | | $112.07 | $168.39 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.31 / $104.79 / $179.34
| Professional | | $64.31 | $104.79 | $179.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.99 / $224.30 / $342.78
| Professional | | $116.99 | $224.30 | $342.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.79 / $169.34 / $530.40
| Facility | | $130.79 | $169.34 | $530.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.78 / $171.78 / $171.78
| Professional | | $171.78 | $171.78 | $171.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.00 / $255.18 / $566.91
| Facility | | $110.00 | $255.18 | $566.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.55 / $145.65 / $702.98
| Professional | | $94.55 | $145.65 | $702.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.68 / $108.68 / $108.68
| Facility | | $108.68 | $108.68 | $108.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.82 / $134.94 / $326.58
| Professional | | $89.82 | $134.94 | $326.58 |