- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.13 / $73.13 / $87.33
| Facility | | $73.13 | $73.13 | $87.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.17 / $87.33 / $245.90
| Professional | | $69.17 | $87.33 | $245.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.03 / $165.86 / $276.47
| Professional | | $97.03 | $165.86 | $276.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.95 / $208.32 / $286.69
| Professional | | $93.95 | $208.32 | $286.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.13 / $93.95 / $131.63
| Facility | | $73.13 | $93.95 | $131.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.31 / $102.18 / $383.01
| Facility | | $75.31 | $102.18 | $383.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.77 / $154.46 / $265.33
| Professional | | $99.77 | $154.46 | $265.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $58.40 / $239.12
| Professional | | $50.00 | $58.40 | $239.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.13 / $93.95 / $131.63
| Facility | | $73.13 | $93.95 | $131.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.75 / $236.39 / $305.64
| Professional | | $189.75 | $236.39 | $305.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.06 / $160.06 / $383.01
| Facility | | $160.06 | $160.06 | $383.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.04 / $96.04 / $116.30
| Professional | | $96.04 | $96.04 | $116.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.78 / $101.78 / $120.58
| Professional | | $101.78 | $101.78 | $120.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.12 / $173.58 / $210.18
| Professional | | $140.12 | $173.58 | $210.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.77 / $167.67 / $274.64
| Professional | | $99.77 | $167.67 | $274.64 |