- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.20 / $157.83 / $226.33
| Facility | | $75.20 | $157.83 | $226.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $75.09 / $159.06
| Professional | | $74.36 | $75.09 | $159.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.87 / $80.67 / $8,459.92
| Facility | | $68.87 | $80.67 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.16 / $77.16 / $77.16
| Professional | | $77.16 | $77.16 | $77.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.15 / $74.36 / $74.36
| Facility | | $70.15 | $74.36 | $74.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $74.36 / $77.17
| Professional | | $74.36 | $74.36 | $77.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $74.36 / $93.02
| Professional | | $74.36 | $74.36 | $93.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.53 / $52.53 / $55.96
| Facility | | $52.53 | $52.53 | $55.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.55 / $82.55 / $82.55
| Professional | | $82.55 | $82.55 | $82.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.20 / $118.00 / $226.33
| Facility | | $75.20 | $118.00 | $226.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $76.59 / $226.33
| Professional | | $74.36 | $76.59 | $226.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $117.60 / $143.00
| Professional | | $27.40 | $117.60 | $143.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.15 / $74.36 / $74.36
| Facility | | $70.15 | $74.36 | $74.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $74.36 / $79.26
| Professional | | $74.36 | $74.36 | $79.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.86 / $66.86 / $77.59
| Facility | | $66.86 | $66.86 | $77.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.86 / $66.86 / $77.59
| Professional | | $66.86 | $66.86 | $77.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.36 / $78.81 / $96.09
| Professional | | $74.36 | $78.81 | $96.09 |