- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.87 / $100.87 / $123.69
| Facility | | $100.87 | $100.87 | $123.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.34 / $104.68 / $123.69
| Professional | | $83.34 | $104.68 | $123.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.85 / $104.85 / $151.37
| Professional | | $104.85 | $104.85 | $151.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $8,639.91 / $79,506.39
| Facility | | $8,459.92 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.28 / $112.36 / $201.70
| Professional | | $108.28 | $112.36 | $201.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.10 / $124.10 / $124.10
| Facility | | $124.10 | $124.10 | $124.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.42 / $96.42 / $96.42
| Professional | | $96.42 | $96.42 | $96.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.21 / $236.21 / $236.21
| Facility | | $236.21 | $236.21 | $236.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.20 / $158.40 / $221.43
| Professional | | $123.20 | $158.40 | $221.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.77 / $109.77 / $111.82
| Professional | | $103.77 | $109.77 | $111.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.87 / $100.87 / $123.69
| Facility | | $100.87 | $100.87 | $123.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.76 / $107.65 / $196.23
| Professional | | $90.76 | $107.65 | $196.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.00 / $212.60 / $279.20
| Professional | | $184.00 | $212.60 | $279.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.10 / $124.10 / $124.10
| Facility | | $124.10 | $124.10 | $124.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.42 / $96.42 / $96.42
| Professional | | $96.42 | $96.42 | $96.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.07 / $106.83 / $106.83
| Facility | | $98.07 | $106.83 | $106.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.19 / $106.83 / $111.24
| Professional | | $104.19 | $106.83 | $111.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.57 / $119.99 / $209.97
| Professional | | $95.57 | $119.99 | $209.97 |