- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $81.28 / $575.44
| Facility | | $50.12 | $81.28 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $100.00 / $269.15
| Professional | | $81.28 | $100.00 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $85.11 / $120.23
| Professional | | $66.07 | $85.11 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $107.15 / $169.82
| Professional | | $102.33 | $107.15 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $147.91 / $147.91
| Facility | | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $102.33 / $181.97
| Professional | | $69.18 | $102.33 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $154.88 / $229.09
| Professional | | $107.15 | $154.88 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $93.33
| Facility | | $89.13 | $89.13 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $107.15 / $208.93
| Professional | | $83.18 | $107.15 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $102.33 / $165.96
| Professional | | $77.62 | $102.33 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $77.62 / $575.44
| Facility | | $50.12 | $77.62 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $112.20 / $257.04
| Professional | | $83.18 | $112.20 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $87.10 / $109.65
| Professional | | $74.13 | $87.10 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $85.11 / $120.23
| Professional | | $70.79 | $85.11 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $85.11 / $309.03
| Professional | | $5.25 | $85.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $338.84
| Facility | | $181.97 | $275.42 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $97.72 / $177.83
| Professional | | $75.86 | $97.72 | $177.83 |