- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.09 / $196.27 / $861.41
| Facility | | $71.09 | $196.27 | $861.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.32 / $108.89 / $1,120.00
| Professional | | $106.32 | $108.89 | $1,120.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.40 / $420.92 / $818.35
| Facility | | $133.40 | $420.92 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.05 / $382.99 / $739.96
| Professional | | $127.05 | $382.99 | $739.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.99 / $440.16 / $810.76
| Facility | | $256.99 | $440.16 | $810.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.99 / $109.99 / $109.99
| Facility | | $109.99 | $109.99 | $109.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.99 / $109.99 / $109.99
| Professional | | $109.99 | $109.99 | $109.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.66 / $212.78 / $8,090.00
| Facility | | $134.66 | $212.78 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.53 / $188.54 / $272.89
| Professional | | $154.53 | $188.54 | $272.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.89 / $108.89 / $175.64
| Professional | | $108.89 | $108.89 | $175.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $662.25
| Facility | | $257.04 | $257.04 | $662.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.99 / $450.58 / $739.96
| Professional | | $382.99 | $450.58 | $739.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.98 / $73.98 / $73.98
| Facility | | $73.98 | $73.98 | $73.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.98 / $90.70 / $162.76
| Professional | | $73.98 | $90.70 | $162.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.89 / $450.58 / $745.28
| Professional | | $108.89 | $450.58 | $745.28 |