- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.73 / $191.67 / $249.01
| Facility | | $82.73 | $191.67 | $249.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.08 / $82.08 / $90.28
| Professional | | $82.08 | $82.08 | $90.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.01 / $89.04 / $8,459.92
| Facility | | $76.01 | $89.04 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.17 / $85.17 / $85.17
| Professional | | $85.17 | $85.17 | $85.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.43 / $82.07 / $82.07
| Facility | | $77.43 | $82.07 | $82.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.07 / $82.07 / $82.64
| Professional | | $82.07 | $82.07 | $82.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.07 / $82.07 / $102.67
| Professional | | $82.07 | $82.07 | $102.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.32 / $198.92 / $354.10
| Facility | | $130.32 | $198.92 | $354.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.73 / $139.81 / $51,676.39
| Facility | | $82.73 | $139.81 | $51,676.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.08 / $82.73 / $139.81
| Professional | | $82.08 | $82.73 | $139.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $27.40 / $121.47
| Professional | | $27.40 | $27.40 | $121.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.43 / $82.07 / $82.07
| Facility | | $77.43 | $82.07 | $82.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.07 / $82.07 / $85.17
| Professional | | $82.07 | $82.07 | $85.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.76 / $70.76 / $82.11
| Facility | | $70.76 | $70.76 | $82.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.76 / $70.76 / $82.11
| Professional | | $70.76 | $70.76 | $82.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.08 / $87.00 / $107.11
| Professional | | $82.08 | $87.00 | $107.11 |