- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.39 / $95.78 / $106.60
| Facility | | $81.39 | $95.78 | $106.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.67 / $89.85 / $113.26
| Professional | | $80.67 | $89.85 | $113.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.64 / $96.05 / $174.40
| Professional | | $81.64 | $96.05 | $174.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.54 / $150.54 / $150.54
| Facility | | $150.54 | $150.54 | $150.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.54 / $150.54 / $150.54
| Professional | | $150.54 | $150.54 | $150.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.00 / $118.00 / $118.00
| Facility | | $118.00 | $118.00 | $118.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.55 / $92.55 / $92.55
| Professional | | $92.55 | $92.55 | $92.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.08 / $227.87 / $382.97
| Facility | | $116.08 | $227.87 | $382.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.08 / $163.72 / $246.09
| Professional | | $116.08 | $163.72 | $246.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.25 / $97.45 / $101.94
| Facility | | $85.25 | $97.45 | $101.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.25 / $112.53 / $175.00
| Professional | | $85.25 | $112.53 | $175.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.00 / $118.00 / $74,999.25
| Facility | | $118.00 | $118.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.55 / $93.90 / $257.91
| Professional | | $92.55 | $93.90 | $257.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.28 / $117.26 / $244.87
| Professional | | $78.28 | $117.26 | $244.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.45 / $112.53 / $112.53
| Facility | | $97.45 | $112.53 | $112.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.27 / $112.53 / $189.81
| Professional | | $92.27 | $112.53 | $189.81 |