- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.03 / $131.00 / $131.00
| Facility | | $116.03 | $131.00 | $131.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.64 / $115.82 / $143.12
| Professional | | $97.64 | $115.82 | $143.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.16 / $169.48 / $446.34
| Facility | | $140.16 | $169.48 | $446.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.30 / $156.07 / $300.80
| Professional | | $120.30 | $156.07 | $300.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $137.66 / $213.98
| Professional | | $100.00 | $137.66 | $213.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.22 / $145.22 / $152.33
| Professional | | $145.22 | $145.22 | $152.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.76 / $190.41 / $247.53
| Professional | | $141.76 | $190.41 | $247.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.92 / $151.43 / $267.60
| Professional | | $111.92 | $151.43 | $267.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.90 / $652.90 / $652.90
| Facility | | $652.90 | $652.90 | $652.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.20 / $920.30 / $1,349.40
| Professional | | $732.20 | $920.30 | $1,349.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.17 / $155.35 / $214.19
| Facility | | $113.17 | $155.35 | $214.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.66 / $145.22 / $242.97
| Professional | | $131.66 | $145.22 | $242.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.57 / $415.57 / $415.57
| Professional | | $415.57 | $415.57 | $415.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.48 / $145.74 / $401.82
| Professional | | $102.48 | $145.74 | $401.82 |