- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.76 / $170.82 / $276.74
| Facility | | $122.76 | $170.82 | $276.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.08 / $160.66 / $334.24
| Professional | | $97.08 | $160.66 | $334.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.03 / $555.89 / $555.89
| Facility | | $106.03 | $555.89 | $555.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.19 / $273.30 / $944.96
| Professional | | $131.19 | $273.30 | $944.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.03 / $232.50 / $331.00
| Professional | | $165.03 | $232.50 | $331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.08 / $152.08 / $152.08
| Facility | | $152.08 | $152.08 | $152.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.52 / $211.70 / $360.72
| Professional | | $118.52 | $211.70 | $360.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.97 / $113.97 / $145.26
| Facility | | $113.97 | $113.97 | $145.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.91 / $209.50 / $246.48
| Professional | | $190.91 | $209.50 | $246.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.44 / $306.76 / $408.30
| Professional | | $162.44 | $306.76 | $408.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.04 / $239.64 / $458.57
| Professional | | $185.04 | $239.64 | $458.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.89 / $555.89 / $555.89
| Facility | | $555.89 | $555.89 | $555.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.32 / $296.80 / $944.96
| Professional | | $148.32 | $296.80 | $944.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.33 / $92.30 / $139.44
| Facility | | $77.33 | $92.30 | $139.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.80 / $142.19 / $276.93
| Professional | | $92.80 | $142.19 | $276.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.63 / $209.43 / $385.01
| Professional | | $139.63 | $209.43 | $385.01 |