- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.01 / $73.17 / $73.17
| Facility | | $70.01 | $73.17 | $73.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.69 / $73.17 / $88.33
| Professional | | $67.69 | $73.17 | $88.33 |
- 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
- $90.93 / $94.36 / $172.96
| Professional | | $90.93 | $94.36 | $172.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.82 / $105.82 / $105.82
| Facility | | $105.82 | $105.82 | $105.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.45 / $79.45 / $79.45
| Professional | | $79.45 | $79.45 | $79.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.35 / $193.35 / $193.35
| Facility | | $193.35 | $193.35 | $193.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.28 / $130.37 / $182.89
| Professional | | $101.28 | $130.37 | $182.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.01 / $73.17 / $73.17
| Facility | | $70.01 | $73.17 | $73.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.69 / $75.41 / $92.56
| Professional | | $67.69 | $75.41 | $92.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.10 / $216.40 / $216.40
| Professional | | $176.10 | $216.40 | $216.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.82 / $105.82 / $105.82
| Facility | | $105.82 | $105.82 | $105.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.45 / $79.45 / $79.45
| Professional | | $79.45 | $79.45 | $79.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.41 / $89.41 / $104.26
| Facility | | $89.41 | $89.41 | $104.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.98 / $90.63 / $91.22
| Professional | | $85.98 | $90.63 | $91.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.26 / $104.85 / $176.33
| Professional | | $80.26 | $104.85 | $176.33 |