- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.89 / $175.00 / $296.10
| Facility | | $105.89 | $175.00 | $296.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.23 / $117.19 / $351.36
| Professional | | $100.23 | $117.19 | $351.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.91 / $230.90 / $382.04
| Facility | | $209.91 | $230.90 | $382.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.22 / $195.22 / $258.18
| Professional | | $195.22 | $195.22 | $258.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.01 / $449.21 / $449.21
| Facility | | $151.01 | $449.21 | $449.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.54 / $463.86 / $876.13
| Facility | | $140.54 | $463.86 | $876.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.59 / $349.60 / $397.28
| Professional | | $102.59 | $349.60 | $397.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.40 / $158.84 / $241.40
| Facility | | $60.40 | $158.84 | $241.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.20 / $204.94 / $251.89
| Professional | | $120.20 | $204.94 | $251.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.56 / $220.41 / $977.65
| Facility | | $104.56 | $220.41 | $977.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.74 / $112.75 / $228.57
| Professional | | $92.74 | $112.75 | $228.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $65.00 / $103.34
| Professional | | $50.00 | $65.00 | $103.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.40 / $158.84 / $241.40
| Facility | | $60.40 | $158.84 | $241.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.20 / $204.94 / $251.89
| Professional | | $120.20 | $204.94 | $251.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.91 / $323.05 / $561.07
| Professional | | $209.91 | $323.05 | $561.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.54 / $409.98 / $977.65
| Facility | | $140.54 | $409.98 | $977.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.59 / $140.54 / $1,056.91
| Professional | | $102.59 | $140.54 | $1,056.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.91 / $209.91 / $209.91
| Professional | | $209.91 | $209.91 | $209.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.62 / $209.91 / $209.91
| Professional | | $167.62 | $209.91 | $209.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.98 / $104.72 / $200.72
| Professional | | $77.98 | $104.72 | $200.72 |