- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.88 / $174.27 / $276.74
| Facility | | $131.88 | $174.27 | $276.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.31 / $167.09 / $346.23
| Professional | | $106.31 | $167.09 | $346.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.57 / $596.98 / $596.98
| Facility | | $113.57 | $596.98 | $596.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.97 / $302.70 / $1,021.95
| Professional | | $146.97 | $302.70 | $1,021.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.52 / $249.71 / $351.61
| Professional | | $177.52 | $249.71 | $351.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.28 / $163.28 / $163.28
| Facility | | $163.28 | $163.28 | $163.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.08 / $227.75 / $390.02
| Professional | | $129.08 | $227.75 | $390.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.39 / $122.39 / $155.99
| Facility | | $122.39 | $122.39 | $155.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.59 / $227.67 / $267.83
| Professional | | $207.59 | $227.67 | $267.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.44 / $330.23 / $443.75
| Professional | | $174.44 | $330.23 | $443.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.57 / $273.30 / $472.31
| Professional | | $215.57 | $273.30 | $472.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.98 / $596.98 / $596.98
| Facility | | $596.98 | $596.98 | $596.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.15 / $334.46 / $1,021.95
| Professional | | $164.15 | $334.46 | $1,021.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.72 / $172.31 / $310.33
| Professional | | $129.72 | $172.31 | $310.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.40 / $231.62 / $446.23
| Professional | | $159.40 | $231.62 | $446.23 |