- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.84 / $122.61 / $154.47
| Facility | | $118.84 | $122.61 | $154.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.13 / $121.13 / $151.06
| Professional | | $100.13 | $121.13 | $151.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.90 / $120.83 / $120.83
| Professional | | $115.90 | $120.83 | $120.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.31 / $136.27 / $252.90
| Professional | | $131.31 | $136.27 | $252.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.86 / $197.86 / $197.86
| Facility | | $197.86 | $197.86 | $197.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.29 / $146.68 / $268.31
| Professional | | $105.29 | $146.68 | $268.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.00 / $149.52 / $196.40
| Professional | | $89.00 | $149.52 | $196.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.02 / $150.34 / $303.55
| Professional | | $116.02 | $150.34 | $303.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.84 / $132.04 / $278.80
| Facility | | $118.84 | $132.04 | $278.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.17 / $128.40 / $191.97
| Professional | | $102.17 | $128.40 | $191.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.81 / $109.31 / $133.08
| Professional | | $99.81 | $109.31 | $133.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.81 / $129.15 / $144.90
| Professional | | $99.81 | $129.15 | $144.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.86 / $197.86 / $197.86
| Facility | | $197.86 | $197.86 | $197.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.00 / $145.18 / $276.22
| Professional | | $103.00 | $145.18 | $276.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.67 / $123.93 / $149.15
| Facility | | $122.67 | $123.93 | $149.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.67 / $128.75 / $161.15
| Professional | | $122.67 | $128.75 | $161.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.57 / $140.28 / $255.66
| Professional | | $113.57 | $140.28 | $255.66 |