- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.01 / $66.01 / $66.01
| Facility | | $66.01 | $66.01 | $66.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.50 / $66.01 / $96.55
| Professional | | $36.50 | $66.01 | $96.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.79 / $320.76 / $636.98
| Facility | | $106.79 | $320.76 | $636.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.35 / $101.70 / $147.54
| Professional | | $55.35 | $101.70 | $147.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.36 / $195.09 / $251.24
| Facility | | $160.36 | $195.09 | $251.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.18 / $139.78 / $193.72
| Professional | | $102.18 | $139.78 | $193.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.80 / $87.38 / $105.92
| Facility | | $70.80 | $87.38 | $105.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.68 / $51.68 / $131.25
| Professional | | $51.68 | $51.68 | $131.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.32 / $122.32 / $128.44
| Professional | | $122.32 | $122.32 | $128.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.01 / $72.00 / $72.00
| Facility | | $54.01 | $72.00 | $72.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.00 / $72.00 / $81.14
| Professional | | $72.00 | $72.00 | $81.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.02 / $636.98 / $636.98
| Facility | | $230.02 | $636.98 | $636.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.25 / $75.37 / $147.54
| Professional | | $50.25 | $75.37 | $147.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.75 / $102.75 / $117.92
| Professional | | $102.75 | $102.75 | $117.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.25 / $75.37 / $126.57
| Professional | | $50.25 | $75.37 | $126.57 |