- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.26 / $197.05 / $256.93
| Facility | | $154.26 | $197.05 | $256.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.75 / $191.51 / $280.69
| Professional | | $145.75 | $191.51 | $280.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.90 / $195.34 / $477.67
| Professional | | $156.90 | $195.34 | $477.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.57 / $271.57 / $271.57
| Facility | | $271.57 | $271.57 | $271.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.57 / $271.57 / $271.57
| Professional | | $271.57 | $271.57 | $271.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.12 / $193.12 / $193.12
| Facility | | $193.12 | $193.12 | $193.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.69 / $149.69 / $149.69
| Professional | | $149.69 | $149.69 | $149.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.41 / $250.00 / $440.33
| Facility | | $165.41 | $250.00 | $440.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.91 / $248.23 / $338.56
| Professional | | $188.91 | $248.23 | $338.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.43 / $183.21 / $315.54
| Professional | | $146.43 | $183.21 | $315.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.12 / $555.00 / $74,999.25
| Facility | | $193.12 | $555.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.69 / $195.70 / $483.44
| Professional | | $149.69 | $195.70 | $483.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.51 / $224.35 / $486.52
| Professional | | $144.51 | $224.35 | $486.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.47 / $181.47 / $183.44
| Facility | | $181.47 | $181.47 | $183.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.26 / $201.16 / $360.50
| Professional | | $154.26 | $201.16 | $360.50 |