- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.72 / $124.09 / $180.52
| Professional | | $96.72 | $124.09 | $180.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.30 / $202.30 / $234.81
| Facility | | $202.30 | $202.30 | $234.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.15 / $83.15 / $185.12
| Facility | | $83.15 | $83.15 | $185.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.70 / $70.68 / $158.74
| Professional | | $60.70 | $70.68 | $158.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.04 / $970.44 / $970.44
| Facility | | $311.04 | $970.44 | $970.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.63 / $160.52 / $234.81
| Facility | | $143.63 | $160.52 | $234.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.97 / $162.02 / $202.30
| Professional | | $19.97 | $162.02 | $202.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.15 / $143.63 / $234.81
| Facility | | $83.15 | $143.63 | $234.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.70 / $83.15 / $158.74
| Professional | | $60.70 | $83.15 | $158.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.02 / $108.31 / $153.44
| Professional | | $81.02 | $108.31 | $153.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.11 / $153.44 / $153.44
| Professional | | $138.11 | $153.44 | $153.44 |