- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $74.13 / $85.11
| Facility | | $67.61 | $74.13 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $75.86 / $114.82
| Professional | | $61.66 | $75.86 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $89.13 / $190.55
| Professional | | $70.79 | $89.13 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $74.13 / $186.21
| Facility | | $58.88 | $74.13 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $83.18 / $173.78
| Professional | | $63.10 | $83.18 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $95.50 / $165.96
| Professional | | $77.62 | $95.50 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $100.00 / $177.83
| Professional | | $77.62 | $100.00 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $83.18 / $120.23
| Professional | | $70.79 | $83.18 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $77.62 / $117.49
| Professional | | $56.23 | $77.62 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $467.74
| Facility | | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Professional | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $81.28 / $114.82
| Facility | | $63.10 | $81.28 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $97.72 / $177.83
| Professional | | $77.62 | $97.72 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $93.33 / $120.23
| Professional | | $66.07 | $93.33 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $91.20 / $190.55
| Professional | | $64.57 | $91.20 | $190.55 |