- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $138.04 / $154.88
| Facility | | $70.79 | $138.04 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $70.79 / $93.33
| Professional | | $58.88 | $70.79 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $104.71 / $204.17
| Professional | | $74.13 | $104.71 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $257.04 / $407.38
| Facility | | $218.78 | $257.04 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $186.21 / $239.88
| Professional | | $97.72 | $186.21 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $77.62 / $102.33
| Facility | | $61.66 | $77.62 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $154.88 / $223.87
| Professional | | $102.33 | $154.88 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $77.62 / $109.65
| Facility | | $64.57 | $77.62 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $169.82 / $512.86
| Professional | | $95.50 | $169.82 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $134.90 / $229.09
| Professional | | $87.10 | $134.90 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $467.74
| Facility | | $138.04 | $138.04 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $199.53 / $512.86
| Professional | | $93.33 | $199.53 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $138.04 / $169.82
| Professional | | $87.10 | $138.04 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $128.82 / $223.87
| Professional | | $87.10 | $128.82 | $223.87 |