- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.11 / $88.55 / $118.06
| Facility | | $76.11 | $88.55 | $118.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.15 / $75.02 / $102.47
| Professional | | $59.15 | $75.02 | $102.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.39 / $318.39 / $318.39
| Facility | | $318.39 | $318.39 | $318.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.16 / $127.53 / $491.49
| Professional | | $74.16 | $127.53 | $491.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.56 / $200.22 / $238.04
| Facility | | $76.56 | $200.22 | $238.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.76 / $114.84 / $174.79
| Professional | | $74.76 | $114.84 | $174.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $84.00 / $189.65
| Professional | | $60.00 | $84.00 | $189.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.46 / $120.46 / $135.88
| Facility | | $120.46 | $120.46 | $135.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.88 / $120.46 / $120.46
| Professional | | $81.88 | $120.46 | $120.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.03 / $144.69 / $204.60
| Professional | | $76.03 | $144.69 | $204.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.02 / $139.27 / $278.54
| Facility | | $124.02 | $139.27 | $278.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.07 / $124.07 / $266.67
| Professional | | $124.07 | $124.07 | $266.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.39 / $318.39 / $318.39
| Facility | | $318.39 | $318.39 | $318.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.00 / $125.15 / $491.49
| Professional | | $82.00 | $125.15 | $491.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.80 / $102.21 / $220.92
| Professional | | $78.80 | $102.21 | $220.92 |