- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.26 / $129.06 / $276.74
| Facility | | $92.26 | $129.06 | $276.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.39 / $134.94 / $290.14
| Professional | | $72.39 | $134.94 | $290.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.30 / $419.47 / $419.47
| Facility | | $79.30 | $419.47 | $419.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.53 / $215.50 / $732.11
| Professional | | $99.53 | $215.50 | $732.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.61 / $176.55 / $249.92
| Professional | | $124.61 | $176.55 | $249.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.80 / $114.80 / $114.80
| Facility | | $114.80 | $114.80 | $114.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.91 / $162.66 / $273.43
| Professional | | $93.91 | $162.66 | $273.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.03 / $86.03 / $109.64
| Facility | | $86.03 | $86.03 | $109.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.07 / $159.51 / $187.66
| Professional | | $148.07 | $159.51 | $187.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.33 / $232.26 / $320.08
| Professional | | $123.33 | $232.26 | $320.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.64 / $368.64 / $368.64
| Facility | | $368.64 | $368.64 | $368.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.31 / $186.35 / $355.84
| Professional | | $131.31 | $186.35 | $355.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.47 / $419.47 / $419.47
| Facility | | $419.47 | $419.47 | $419.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.49 / $239.76 / $732.11
| Professional | | $113.49 | $239.76 | $732.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.14 / $65.92 / $104.81
| Facility | | $41.14 | $65.92 | $104.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.56 / $107.64 / $226.72
| Professional | | $68.56 | $107.64 | $226.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.00 / $161.63 / $302.14
| Professional | | $105.00 | $161.63 | $302.14 |