- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.29 / $80.06 / $103.04
| Facility | | $54.29 | $80.06 | $103.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.11 / $56.71 / $83.72
| Professional | | $44.11 | $56.71 | $83.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $261.35 / $261.35
| Facility | | $100.00 | $261.35 | $261.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.45 / $135.25 / $427.68
| Professional | | $71.45 | $135.25 | $427.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.11 / $101.71 / $133.66
| Professional | | $96.11 | $101.71 | $133.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.75 / $104.11 / $172.93
| Professional | | $61.75 | $104.11 | $172.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.49 / $52.49 / $67.93
| Facility | | $52.49 | $52.49 | $67.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.07 / $101.67 / $168.29
| Professional | | $63.07 | $101.67 | $168.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $261.35 / $261.35
| Facility | | $100.00 | $261.35 | $261.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.45 / $135.33 / $427.68
| Professional | | $73.45 | $135.33 | $427.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.98 / $96.79 / $166.65
| Professional | | $70.98 | $96.79 | $166.65 |