- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.84 / $111.85 / $158.28
| Facility | | $78.84 | $111.85 | $158.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.60 / $111.85 / $258.35
| Professional | | $61.60 | $111.85 | $258.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.28 / $356.87 / $356.87
| Facility | | $68.28 | $356.87 | $356.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.39 / $188.04 / $655.29
| Professional | | $86.39 | $188.04 | $655.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.81 / $157.75 / $247.14
| Professional | | $105.81 | $157.75 | $247.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.37 / $97.37 / $97.37
| Facility | | $97.37 | $97.37 | $97.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.31 / $140.53 / $234.48
| Professional | | $81.31 | $140.53 | $234.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.08 / $73.08 / $93.15
| Facility | | $73.08 | $73.08 | $93.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.58 / $142.26 / $167.36
| Professional | | $133.58 | $142.26 | $167.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.97 / $197.32 / $284.62
| Professional | | $108.97 | $197.32 | $284.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.07 / $177.41 / $330.90
| Professional | | $121.07 | $177.41 | $330.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.87 / $356.87 / $356.87
| Facility | | $356.87 | $356.87 | $356.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.10 / $213.00 / $655.29
| Professional | | $101.10 | $213.00 | $655.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.04 / $59.30 / $90.05
| Facility | | $49.04 | $59.30 | $90.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.30 / $91.15 / $193.71
| Professional | | $59.30 | $91.15 | $193.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.49 / $158.05 / $293.06
| Professional | | $95.49 | $158.05 | $293.06 |