- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.55 / $101.63 / $145.06
| Facility | | $79.55 | $101.63 | $145.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.08 / $91.36 / $129.00
| Professional | | $69.08 | $91.36 | $129.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.90 / $363.90 / $363.90
| Facility | | $363.90 | $363.90 | $363.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.21 / $162.26 / $633.97
| Professional | | $89.21 | $162.26 | $633.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.41 / $209.29 / $248.82
| Facility | | $87.41 | $209.29 | $248.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.41 / $132.25 / $219.62
| Professional | | $87.41 | $132.25 | $219.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.00 / $102.00 / $216.00
| Professional | | $77.00 | $102.00 | $216.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.53 / $111.85 / $138.69
| Facility | | $100.53 | $111.85 | $138.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.53 / $105.66 / $123.42
| Professional | | $100.53 | $105.66 | $123.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.16 / $172.16 / $260.14
| Professional | | $92.16 | $172.16 | $260.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.36 / $260.68 / $292.73
| Facility | | $146.36 | $260.68 | $292.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.11 / $651.95 / $1,998.44
| Professional | | $184.11 | $651.95 | $1,998.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.90 / $363.90 / $363.90
| Facility | | $363.90 | $363.90 | $363.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.92 / $164.89 / $633.97
| Professional | | $101.92 | $164.89 | $633.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.05 / $126.11 / $275.54
| Professional | | $98.05 | $126.11 | $275.54 |