- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.16 / $132.13 / $188.43
| Professional | | $72.16 | $132.13 | $188.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.82 / $152.99 / $157.00
| Professional | | $93.82 | $152.99 | $157.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.16 / $139.97 / $249.08
| Facility | | $19.16 | $139.97 | $249.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.16 / $139.97 / $249.08
| Professional | | $19.16 | $139.97 | $249.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.00 / $112.73 / $112.73
| Facility | | $112.00 | $112.73 | $112.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.55 / $112.73 / $173.88
| Professional | | $16.55 | $112.73 | $173.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $332.00 / $332.00
| Facility | | $319.00 | $332.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.11 / $130.11 / $171.96
| Professional | | $110.11 | $130.11 | $171.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.53 / $149.46 / $158.80
| Professional | | $146.53 | $149.46 | $158.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.19 / $146.19 / $146.19
| Professional | | $146.19 | $146.19 | $146.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.00 / $112.73 / $112.73
| Facility | | $112.00 | $112.73 | $112.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.55 / $112.73 / $173.88
| Professional | | $16.55 | $112.73 | $173.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.17 / $102.26 / $170.15
| Professional | | $68.17 | $102.26 | $170.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.46 / $149.46 / $149.46
| Facility | | $149.46 | $149.46 | $149.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.46 / $149.46 / $158.80
| Professional | | $149.46 | $149.46 | $158.80 |