- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $478.63
| Facility | | $109.65 | $109.65 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $109.65 / $186.21
| Professional | | $93.33 | $109.65 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $263.03 / $660.69
| Facility | | $114.82 | $263.03 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $141.25 / $323.59
| Professional | | $81.28 | $141.25 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $190.55 / $257.04
| Facility | | $165.96 | $190.55 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $123.03
| Professional | | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $120.23 / $125.89
| Facility | | $89.13 | $120.23 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $154.88 / $371.54
| Professional | | $81.28 | $154.88 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $177.83 / $7,079.46
| Facility | | $83.18 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $102.33 / $177.83
| Professional | | $53.70 | $102.33 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $123.03 / $275.42
| Professional | | $104.71 | $123.03 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $147.91 / $245.47
| Facility | | $147.91 | $147.91 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Professional | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $263.03 / $660.69
| Facility | | $114.82 | $263.03 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $141.25 / $323.59
| Professional | | $83.18 | $141.25 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $102.33 / $102.33
| Facility | | $54.95 | $102.33 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $138.04 / $302.00
| Professional | | $79.43 | $138.04 | $302.00 |