- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.75 / $99.76 / $542.96
| Facility | | $86.75 | $99.76 | $542.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.56 / $98.09 / $372.00
| Professional | | $75.56 | $98.09 | $372.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.20 / $114.64 / $327.41
| Professional | | $78.20 | $114.64 | $327.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.16 / $243.25 / $373.15
| Facility | | $208.16 | $243.25 | $373.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.39 / $186.89 / $230.84
| Professional | | $98.39 | $186.89 | $230.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.29 / $89.45 / $161.47
| Facility | | $80.29 | $89.45 | $161.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.11 / $89.45 / $161.47
| Facility | | $75.11 | $89.45 | $161.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.05 / $154.62 / $509.49
| Professional | | $92.05 | $154.62 | $509.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.49 / $85.00 / $137.47
| Professional | | $49.49 | $85.00 | $137.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.29 / $96.74 / $161.47
| Facility | | $80.29 | $96.74 | $161.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.84 / $194.83 / $270.60
| Professional | | $132.84 | $194.83 | $270.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.39 / $372.39 / $372.39
| Facility | | $372.39 | $372.39 | $372.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.67 / $343.76 / $509.49
| Professional | | $91.67 | $343.76 | $509.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.19 / $126.19 / $126.19
| Professional | | $126.19 | $126.19 | $126.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.66 / $312.58 / $312.58
| Professional | | $126.66 | $312.58 | $312.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.62 / $144.81 / $306.35
| Professional | | $90.62 | $144.81 | $306.35 |