- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $63.10
| Facility | | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $64.57 / $81.28
| Professional | | $56.23 | $64.57 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $117.49 / $213.80
| Professional | | $72.44 | $117.49 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $229.09 / $363.08
| Facility | | $194.98 | $229.09 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $112.20 / $138.04
| Professional | | $66.07 | $112.20 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $69.18 / $97.72
| Facility | | $58.88 | $69.18 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $138.04 / $223.87
| Professional | | $77.62 | $138.04 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $70.79 / $104.71
| Facility | | $60.26 | $70.79 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $141.25 / $467.74
| Professional | | $87.10 | $141.25 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $120.23 / $234.42
| Professional | | $83.18 | $120.23 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $467.74
| Facility | | $141.25 | $141.25 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $380.19 / $467.74
| Professional | | $66.07 | $380.19 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $181.97
| Professional | | $81.28 | $81.28 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $123.03 / $208.93
| Professional | | $85.11 | $123.03 | $208.93 |