- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.01 / $147.02 / $481.12
| Facility | | $109.01 | $147.02 | $481.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.63 / $109.01 / $158.06
| Professional | | $84.63 | $109.01 | $158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.35 / $230.53 / $534.23
| Facility | | $90.35 | $230.53 | $534.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.33 / $144.76 / $313.14
| Professional | | $81.33 | $144.76 | $313.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.28 / $188.76 / $243.78
| Facility | | $160.28 | $188.76 | $243.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.82 / $123.82 / $123.82
| Professional | | $123.82 | $123.82 | $123.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.00 / $115.00 / $125.00
| Facility | | $90.00 | $115.00 | $125.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.42 / $172.04 / $374.02
| Professional | | $93.42 | $172.04 | $374.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.60 / $158.05 / $6,679.00
| Facility | | $104.60 | $158.05 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.02 / $99.34 / $168.88
| Professional | | $60.02 | $99.34 | $168.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.63 / $208.28 / $318.30
| Professional | | $108.63 | $208.28 | $318.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.15 / $147.15 / $242.38
| Facility | | $147.15 | $147.15 | $242.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.29 / $160.29 / $160.29
| Professional | | $160.29 | $160.29 | $160.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.53 / $534.23 / $534.23
| Facility | | $230.53 | $534.23 | $534.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.33 / $154.69 / $657.65
| Professional | | $81.33 | $154.69 | $657.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.33 / $135.18 / $308.29
| Professional | | $81.33 | $135.18 | $308.29 |