- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $112.20 / $1,698.24
| Facility | | $87.10 | $112.20 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $102.33 / $457.09
| Professional | | $75.86 | $102.33 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $194.98 / $512.86
| Facility | | $107.15 | $194.98 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $128.82 / $512.86
| Professional | | $85.11 | $128.82 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $234.42 / $309.03
| Facility | | $199.53 | $234.42 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $154.88 / $213.80
| Professional | | $120.23 | $154.88 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $112.20 / $234.42
| Professional | | $91.20 | $112.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $8,511.38
| Facility | | $83.18 | $131.83 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $87.10 / $162.18
| Professional | | $46.77 | $87.10 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $125.89 / $213.80
| Professional | | $83.18 | $125.89 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $269.15 / $1,202.26
| Facility | | $177.83 | $269.15 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $194.98 / $512.86
| Facility | | $107.15 | $194.98 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $128.82 / $512.86
| Professional | | $85.11 | $128.82 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $123.03 / $229.09
| Professional | | $91.20 | $123.03 | $229.09 |