- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.76 / $149.31 / $189.40
| Facility | | $90.76 | $149.31 | $189.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.94 / $131.18 / $218.06
| Professional | | $72.94 | $131.18 | $218.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $125.83 / $140.55
| Professional | | $100.00 | $125.83 | $140.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.30 / $196.01 / $196.01
| Facility | | $182.30 | $196.01 | $196.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.19 / $180.40 / $452.52
| Professional | | $87.19 | $180.40 | $452.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.71 / $145.24 / $236.27
| Professional | | $91.71 | $145.24 | $236.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.81 / $174.57 / $434.11
| Professional | | $93.81 | $174.57 | $434.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.75 / $141.26 / $227.34
| Professional | | $104.75 | $141.26 | $227.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.07 / $128.94 / $210.67
| Professional | | $83.07 | $128.94 | $210.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.37 / $461.51 / $461.51
| Facility | | $425.37 | $461.51 | $461.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.25 / $578.25 / $951.45
| Professional | | $578.25 | $578.25 | $951.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.22 / $137.53 / $205.68
| Facility | | $80.22 | $137.53 | $205.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.07 / $191.59 / $385.40
| Professional | | $97.07 | $191.59 | $385.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.38 / $230.38 / $409.59
| Professional | | $230.38 | $230.38 | $409.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.21 / $116.37 / $202.15
| Professional | | $95.21 | $116.37 | $202.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.10 / $176.10 / $176.10
| Facility | | $176.10 | $176.10 | $176.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.45 / $165.30 / $508.31
| Professional | | $117.45 | $165.30 | $508.31 |