- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.78 / $163.32 / $11,487.36
| Facility | | $73.78 | $163.32 | $11,487.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.19 / $74.81 / $166.28
| Professional | | $73.19 | $74.81 | $166.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.80 / $79.42 / $8,459.92
| Facility | | $67.80 | $79.42 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.95 / $75.95 / $75.95
| Professional | | $75.95 | $75.95 | $75.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.06 / $73.20 / $73.20
| Facility | | $69.06 | $73.20 | $73.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.20 / $73.20 / $75.95
| Professional | | $73.20 | $73.20 | $75.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.95 / $75.95 / $95.63
| Professional | | $75.95 | $75.95 | $95.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.00 / $151.78 / $243.41
| Facility | | $122.00 | $151.78 | $243.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.78 / $162.16 / $8,819.20
| Facility | | $73.78 | $162.16 | $8,819.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.19 / $80.04 / $184.17
| Professional | | $73.19 | $80.04 | $184.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $111.70 / $152.69
| Professional | | $27.40 | $111.70 | $152.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.06 / $73.20 / $73.20
| Facility | | $69.06 | $73.20 | $73.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.20 / $73.20 / $82.25
| Professional | | $73.20 | $73.20 | $82.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.75 / $70.75 / $82.10
| Facility | | $70.75 | $70.75 | $82.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.75 / $70.75 / $82.10
| Professional | | $70.75 | $70.75 | $82.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.20 / $77.59 / $98.82
| Professional | | $73.20 | $77.59 | $98.82 |