- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.93 / $71.93 / $71.93
| Facility | | $71.93 | $71.93 | $71.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.06 / $80.30 / $308.76
| Professional | | $70.06 | $80.30 | $308.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.79 / $173.41 / $818.35
| Facility | | $97.79 | $173.41 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.23 / $119.28 / $468.55
| Professional | | $78.23 | $119.28 | $468.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.56 / $205.36 / $261.80
| Facility | | $176.56 | $205.36 | $261.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.39 / $131.65 / $372.91
| Professional | | $78.39 | $131.65 | $372.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.12 / $86.12 / $86.12
| Facility | | $86.12 | $86.12 | $86.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.58 / $102.08 / $210.43
| Professional | | $80.58 | $102.08 | $210.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.22 / $113.41 / $8,090.00
| Facility | | $73.22 | $113.41 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.71 / $79.31 / $132.79
| Professional | | $42.71 | $79.31 | $132.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.11 / $168.96 / $221.21
| Professional | | $90.11 | $168.96 | $221.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.40 / $202.16 / $1,211.83
| Facility | | $75.40 | $202.16 | $1,211.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.33 / $151.38 / $552.50
| Professional | | $116.33 | $151.38 | $552.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.20 / $173.20 / $352.69
| Facility | | $173.20 | $173.20 | $352.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.20 / $121.34 / $468.55
| Professional | | $82.20 | $121.34 | $468.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.67 / $110.49 / $267.80
| Professional | | $81.67 | $110.49 | $267.80 |