- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.70 / $95.23 / $127.06
| Facility | | $80.70 | $95.23 | $127.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.09 / $82.52 / $109.73
| Professional | | $66.09 | $82.52 | $109.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.05 / $362.05 / $362.05
| Facility | | $362.05 | $362.05 | $362.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.97 / $150.47 / $555.30
| Professional | | $82.97 | $150.47 | $555.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.55 / $126.39 / $249.69
| Facility | | $100.55 | $126.39 | $249.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.47 / $128.10 / $204.36
| Professional | | $85.47 | $128.10 | $204.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.98 / $91.00 / $214.10
| Professional | | $67.98 | $91.00 | $214.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.20 / $97.79 / $121.49
| Facility | | $93.20 | $97.79 | $121.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.39 / $94.73 / $110.15
| Professional | | $91.39 | $94.73 | $110.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.51 / $165.02 / $232.80
| Professional | | $86.51 | $165.02 | $232.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.28 / $258.56 / $345.51
| Facility | | $129.28 | $258.56 | $345.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.34 / $345.51 / $460.68
| Professional | | $230.34 | $345.51 | $460.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.05 / $362.05 / $362.05
| Facility | | $362.05 | $362.05 | $362.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.58 / $150.47 / $555.30
| Professional | | $90.58 | $150.47 | $555.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.41 / $112.07 / $298.32
| Professional | | $82.41 | $112.07 | $298.32 |