- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.08 / $116.12 / $166.64
| Facility | | $103.08 | $116.12 | $166.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.17 / $109.14 / $193.75
| Professional | | $85.17 | $109.14 | $193.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.70 / $467.26 / $467.26
| Facility | | $88.70 | $467.26 | $467.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.30 / $210.75 / $702.61
| Professional | | $108.30 | $210.75 | $702.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.92 / $108.92 / $138.22
| Facility | | $108.92 | $108.92 | $138.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.76 / $187.45 / $254.65
| Professional | | $138.76 | $187.45 | $254.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.81 / $127.81 / $127.81
| Facility | | $127.81 | $127.81 | $127.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.88 / $161.59 / $274.81
| Professional | | $95.88 | $161.59 | $274.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.80 / $95.80 / $122.10
| Facility | | $95.80 | $95.80 | $122.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.76 / $111.56 / $185.93
| Professional | | $62.76 | $111.56 | $185.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.41 / $244.96 / $310.62
| Professional | | $128.41 | $244.96 | $310.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.23 / $142.61 / $178.92
| Professional | | $121.23 | $142.61 | $178.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.26 / $467.26 / $467.26
| Facility | | $467.26 | $467.26 | $467.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.71 / $228.88 / $702.61
| Professional | | $121.71 | $228.88 | $702.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.18 / $167.52 / $275.30
| Professional | | $115.18 | $167.52 | $275.30 |