- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $275.42
| Facility | | $64.57 | $64.57 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $79.43 / $177.83
| Professional | | $61.66 | $79.43 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $151.36 / $831.76
| Facility | | $131.83 | $151.36 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $112.20 / $151.36
| Professional | | $64.57 | $112.20 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $194.98 / $257.04
| Facility | | $158.49 | $194.98 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $123.03 / $123.03
| Professional | | $97.72 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $102.33 / $104.71
| Facility | | $85.11 | $102.33 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $102.33
| Professional | | $74.13 | $74.13 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $199.53
| Professional | | $128.82 | $128.82 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $93.33
| Facility | | $93.33 | $93.33 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $97.72
| Professional | | $93.33 | $93.33 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $151.36 / $831.76
| Facility | | $131.83 | $151.36 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $114.82 / $151.36
| Professional | | $64.57 | $114.82 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $131.83 / $134.90
| Professional | | $107.15 | $131.83 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.11 / $89.13 / $190.55
| Facility | | $0.11 | $89.13 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $87.10 / $128.82
| Professional | | $60.26 | $87.10 | $128.82 |