- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.68 / $109.01 / $569.85
| Facility | | $96.68 | $109.01 | $569.85 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $436.74 / $563.15 / $997.50
| Facility | 25 | $436.74 | $563.15 | $997.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.35 / $109.01 / $413.29
| Professional | | $91.35 | $109.01 | $413.29 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $101.12 / $408.40 / $1,255.60
| Professional | 25 | $101.12 | $408.40 | $1,255.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.95 / $1.00 / $1,300.00
| Facility | | $0.95 | $1.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.13 / $275.98 / $366.82
| Professional | | $189.13 | $275.98 | $366.82 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $151.57 / $217.92 / $284.14
| Professional | 25 | $151.57 | $217.92 | $284.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.02 / $412.08 / $991.31
| Facility | | $264.02 | $412.08 | $991.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.27 / $303.73 / $459.61
| Professional | | $165.27 | $303.73 | $459.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.02 / $339.14 / $780.56
| Facility | | $264.02 | $339.14 | $780.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.79 / $291.14 / $400.72
| Professional | | $187.79 | $291.14 | $400.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.69 / $165.20 / $295.79
| Facility | | $98.69 | $165.20 | $295.79 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $743.36 / $743.36 / $745.98
| Facility | 25 | $743.36 | $743.36 | $745.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.55 / $309.41 / $671.20
| Professional | | $138.55 | $309.41 | $671.20 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $253.82 / $331.48 / $558.90
| Professional | 25 | $253.82 | $331.48 | $558.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.95 / $246.71 / $396.70
| Professional | | $125.95 | $246.71 | $396.70 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $80.00 / $90.00 / $234.81
| Professional | 25 | $80.00 | $90.00 | $234.81 |