- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.69 / $88.69 / $1,128.34
| Facility | | $88.69 | $88.69 | $1,128.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.26 / $98.09 / $241.30
| Professional | | $78.26 | $98.09 | $241.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.12 / $194.13 / $818.35
| Facility | | $107.12 | $194.13 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.70 / $135.91 / $509.49
| Professional | | $85.70 | $135.91 | $509.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.81 / $232.40 / $296.26
| Facility | | $199.81 | $232.40 | $296.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.91 / $157.30 / $414.11
| Professional | | $116.91 | $157.30 | $414.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.46 / $95.46 / $95.46
| Facility | | $95.46 | $95.46 | $95.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.00 / $114.31 / $247.73
| Professional | | $91.00 | $114.31 | $247.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.52 / $126.27 / $8,090.00
| Facility | | $81.52 | $126.27 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $88.31 / $147.85
| Professional | | $47.55 | $88.31 | $147.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.76 / $188.92 / $244.14
| Professional | | $100.76 | $188.92 | $244.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.57 / $250.68 / $1,211.83
| Facility | | $176.57 | $250.68 | $1,211.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.38 / $140.00 / $246.73
| Professional | | $128.38 | $140.00 | $246.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.13 / $194.13 / $390.64
| Facility | | $194.13 | $194.13 | $390.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.34 / $138.25 / $509.49
| Professional | | $92.34 | $138.25 | $509.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.09 / $123.82 / $223.18
| Professional | | $91.09 | $123.82 | $223.18 |