- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $141.25 / $194.98
| Facility | | $109.65 | $141.25 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $107.15 / $239.88
| Professional | | $89.13 | $107.15 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $100.00 / $186.21
| Professional | | $85.11 | $100.00 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Professional | | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $50,118.72
| Facility | | $169.82 | $169.82 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $151.36 / $354.81
| Professional | | $77.62 | $151.36 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $102.33 / $229.09
| Facility | | $39.81 | $102.33 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $165.96 / $229.09
| Professional | | $112.20 | $165.96 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $128.82 / $223.87
| Professional | | $77.62 | $128.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Professional | | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $50,118.72 / $75,857.76
| Facility | | $120.23 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $144.54 / $281.84
| Professional | | $117.49 | $144.54 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $114.82 / $263.03
| Professional | | $85.11 | $114.82 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $123.03 / $134.90
| Facility | | $77.62 | $123.03 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $125.89 / $269.15
| Professional | | $77.62 | $125.89 | $269.15 |