- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.04 / $125.34 / $182.44
| Facility | | $106.04 | $125.34 | $182.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.63 / $110.01 / $142.59
| Professional | | $90.63 | $110.01 | $142.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.86 / $531.86 / $531.86
| Facility | | $531.86 | $531.86 | $531.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.08 / $203.74 / $747.63
| Professional | | $115.08 | $203.74 | $747.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.50 / $175.35 / $286.52
| Facility | | $139.50 | $175.35 | $286.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.58 / $181.77 / $284.44
| Professional | | $118.58 | $181.77 | $284.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.00 / $121.00 / $296.70
| Professional | | $91.00 | $121.00 | $296.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.73 / $138.94 / $159.79
| Facility | | $107.73 | $138.94 | $159.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.73 / $131.80 / $145.09
| Professional | | $107.73 | $131.80 | $145.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.15 / $239.37 / $334.61
| Professional | | $120.15 | $239.37 | $334.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.46 / $151.46 / $170.01
| Facility | | $151.46 | $151.46 | $170.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.00 / $151.46 / $151.46
| Professional | | $150.00 | $151.46 | $151.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.86 / $531.86 / $531.86
| Facility | | $531.86 | $531.86 | $531.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.98 / $195.76 / $747.63
| Professional | | $121.98 | $195.76 | $747.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.19 / $150.25 / $341.95
| Professional | | $117.19 | $150.25 | $341.95 |