- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.03 / $95.61 / $139.72
| Professional | | $67.03 | $95.61 | $139.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.93 / $11.00 / $251.92
| Facility | | $9.93 | $11.00 | $251.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.00 / $153.90 / $220.13
| Professional | | $110.00 | $153.90 | $220.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.75 / $254.75 / $254.75
| Facility | | $254.75 | $254.75 | $254.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $132.62 / $170.94
| Professional | | $100.00 | $132.62 | $170.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.17 / $64.17 / $170.94
| Facility | | $64.17 | $64.17 | $170.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.54 / $64.17 / $202.50
| Professional | | $54.54 | $64.17 | $202.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.68 / $107.68 / $129.22
| Professional | | $107.68 | $107.68 | $129.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.88 / $169.74 / $801.00
| Professional | | $148.88 | $169.74 | $801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.53 / $821.30 / $851.20
| Facility | | $181.53 | $821.30 | $851.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.50 / $90.35 / $211.33
| Facility | | $21.50 | $90.35 | $211.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.54 / $64.17 / $98.94
| Professional | | $54.54 | $64.17 | $98.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.68 / $107.68 / $107.68
| Professional | | $107.68 | $107.68 | $107.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.31 / $82.95 / $142.38
| Professional | | $72.31 | $82.95 | $142.38 |