- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.64 / $113.12 / $136.33
| Facility | | $97.64 | $113.12 | $136.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.20 / $110.81 / $141.82
| Professional | | $97.20 | $110.81 | $141.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.09 / $115.40 / $192.35
| Professional | | $98.09 | $115.40 | $192.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.13 / $183.13 / $183.13
| Facility | | $183.13 | $183.13 | $183.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.13 / $183.13 / $183.13
| Professional | | $183.13 | $183.13 | $183.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.37 / $170.37 / $170.37
| Facility | | $170.37 | $170.37 | $170.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.22 / $145.22 / $595.55
| Professional | | $145.22 | $145.22 | $595.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.18 / $250.00 / $471.60
| Facility | | $143.18 | $250.00 | $471.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.33 / $255.56 / $390.78
| Professional | | $184.33 | $255.56 | $390.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.07 / $152.12 / $152.12
| Facility | | $104.07 | $152.12 | $152.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.26 / $174.94 / $271.52
| Professional | | $132.26 | $174.94 | $271.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.37 / $170.37 / $74,999.25
| Facility | | $170.37 | $170.37 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.16 / $145.22 / $330.63
| Professional | | $110.16 | $145.22 | $330.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.30 / $159.68 / $299.32
| Professional | | $106.30 | $159.68 | $299.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.38 / $137.38 / $174.59
| Facility | | $137.38 | $137.38 | $174.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.38 / $174.59 / $294.49
| Professional | | $137.38 | $174.59 | $294.49 |