- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $158.49 / $257.04
| Facility | | $109.65 | $158.49 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $138.04 / $288.40
| Professional | | $72.44 | $138.04 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $165.96 / $269.15
| Professional | | $112.20 | $165.96 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $107.15 / $257.04
| Professional | | $85.11 | $107.15 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Facility | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $213.80
| Professional | | $131.83 | $131.83 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $181.97 / $426.58
| Professional | | $89.13 | $181.97 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $169.82
| Facility | | $41.69 | $41.69 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $229.09 / $323.59
| Professional | | $173.78 | $229.09 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $169.82 / $323.59
| Professional | | $107.15 | $169.82 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $223.87 / $537.03
| Professional | | $158.49 | $223.87 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Facility | | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $134.90 / $302.00
| Professional | | $72.44 | $134.90 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $112.20 / $141.25
| Facility | | $77.62 | $112.20 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $162.18 / $302.00
| Professional | | $107.15 | $162.18 | $302.00 |