- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.40 / $94.76 / $416.28
| Facility | | $82.40 | $94.76 | $416.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.88 / $96.42 / $390.00
| Professional | | $79.88 | $96.42 | $390.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.48 / $158.38 / $360.00
| Professional | | $86.48 | $158.38 | $360.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.00 / $334.85 / $457.66
| Facility | | $70.00 | $334.85 | $457.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.99 / $282.14 / $320.61
| Professional | | $135.99 | $282.14 | $320.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.68 / $103.81 / $206.00
| Facility | | $69.68 | $103.81 | $206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.68 / $109.24 / $292.77
| Facility | | $69.68 | $109.24 | $292.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.01 / $148.29 / $437.98
| Professional | | $97.01 | $148.29 | $437.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.78 / $95.09 / $206.29
| Professional | | $59.78 | $95.09 | $206.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.68 / $103.81 / $206.00
| Facility | | $69.68 | $103.81 | $206.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.46 / $251.89 / $356.99
| Professional | | $142.46 | $251.89 | $356.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.00 / $140.78 / $499.54
| Facility | | $65.00 | $140.78 | $499.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.99 / $477.45 / $692.10
| Professional | | $138.99 | $477.45 | $692.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.38 / $161.38 / $161.38
| Facility | | $161.38 | $161.38 | $161.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.15 / $350.57 / $350.57
| Professional | | $158.15 | $350.57 | $350.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.95 / $146.24 / $296.72
| Professional | | $95.95 | $146.24 | $296.72 |