- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.56 / $158.04 / $372.37
| Facility | | $95.56 | $158.04 | $372.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.45 / $91.50 / $315.00
| Professional | | $58.45 | $91.50 | $315.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.26 / $200.40 / $458.69
| Facility | | $129.26 | $200.40 | $458.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.43 / $156.60 / $842.25
| Professional | | $93.43 | $156.60 | $842.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.00 / $108.00 / $118.00
| Facility | | $90.00 | $108.00 | $118.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.89 / $101.29 / $248.85
| Professional | | $69.89 | $101.29 | $248.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.95 / $111.47 / $230.45
| Facility | | $72.95 | $111.47 | $230.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.95 / $111.47 / $210.43
| Professional | | $72.95 | $111.47 | $210.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.84 / $150.94 / $267.04
| Professional | | $27.84 | $150.94 | $267.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.90 / $181.06 / $201.67
| Facility | | $121.90 | $181.06 | $201.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.09 / $180.95 / $267.41
| Facility | | $134.09 | $180.95 | $267.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.60 / $188.34 / $252.15
| Professional | | $135.60 | $188.34 | $252.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.25 / $150.30 / $217.11
| Facility | | $125.25 | $150.30 | $217.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.62 / $103.85 / $173.00
| Professional | | $97.62 | $103.85 | $173.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.63 / $87.70 / $236.93
| Professional | | $81.63 | $87.70 | $236.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.98 / $110.28 / $110.28
| Professional | | $99.98 | $110.28 | $110.28 |