- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.54 / $390.87 / $858.90
| Facility | | $188.54 | $390.87 | $858.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.29 / $149.56 / $367.88
| Professional | | $74.29 | $149.56 | $367.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.55 / $238.55 / $238.55
| Professional | | $238.55 | $238.55 | $238.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.59 / $277.17 / $331.49
| Professional | | $235.59 | $277.17 | $331.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.96 / $302.37 / $559.57
| Professional | | $116.96 | $302.37 | $559.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.26 / $626.26 / $626.26
| Facility | | $626.26 | $626.26 | $626.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.57 / $431.32 / $794.63
| Professional | | $299.57 | $431.32 | $794.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.70 / $106.96 / $109.90
| Professional | | $106.70 | $106.96 | $109.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.54 / $390.87 / $1,197.23
| Facility | | $188.54 | $390.87 | $1,197.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $157.47 / $494.00
| Professional | | $75.00 | $157.47 | $494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.40 / $262.62 / $503.94
| Professional | | $153.40 | $262.62 | $503.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.53 / $302.37 / $571.20
| Professional | | $129.53 | $302.37 | $571.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.22 / $263.95 / $263.95
| Facility | | $160.22 | $263.95 | $263.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.22 / $263.95 / $288.89
| Professional | | $160.22 | $263.95 | $288.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.45 / $97.10 / $251.97
| Professional | | $76.45 | $97.10 | $251.97 |