- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.68 / $143.57 / $202.85
| Facility | | $105.68 | $143.57 | $202.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.16 / $131.47 / $301.74
| Professional | | $79.16 | $131.47 | $301.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.92 / $478.90 / $478.90
| Facility | | $90.92 | $478.90 | $478.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.09 / $241.11 / $842.92
| Professional | | $116.09 | $241.11 | $842.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.41 / $200.33 / $298.16
| Professional | | $142.41 | $200.33 | $298.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.94 / $130.94 / $130.94
| Facility | | $130.94 | $130.94 | $130.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.99 / $181.53 / $311.07
| Professional | | $103.99 | $181.53 | $311.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.18 / $98.18 / $125.13
| Facility | | $98.18 | $98.18 | $125.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.70 / $181.78 / $213.86
| Professional | | $170.70 | $181.78 | $213.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.93 / $264.91 / $364.65
| Professional | | $139.93 | $264.91 | $364.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.75 / $228.60 / $390.48
| Professional | | $196.75 | $228.60 | $390.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.90 / $478.90 / $478.90
| Facility | | $478.90 | $478.90 | $478.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.02 / $264.87 / $842.92
| Professional | | $131.02 | $264.87 | $842.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.04 / $79.12 / $105.00
| Facility | | $63.04 | $79.12 | $105.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.89 / $142.40 / $264.62
| Professional | | $105.89 | $142.40 | $264.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.23 / $184.97 / $344.63
| Professional | | $127.23 | $184.97 | $344.63 |