- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $208.93 / $575.44
| Facility | | $50.12 | $208.93 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $131.83 / $426.58
| Professional | | $97.72 | $131.83 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $223.87 / $1,096.48
| Facility | | $218.78 | $223.87 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $173.78 / $234.42
| Professional | | $95.50 | $173.78 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $295.12 / $398.11
| Facility | | $257.04 | $295.12 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $229.09 / $309.03
| Professional | | $177.83 | $229.09 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Facility | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $95.50 / $138.04
| Professional | | $95.50 | $95.50 | $138.04 |
- 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
- $199.53 / $199.53 / $302.00
| Professional | | $199.53 | $199.53 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $141.25
| Professional | | $138.04 | $138.04 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $223.87 / $1,096.48
| Facility | | $218.78 | $223.87 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $177.83 / $257.04
| Professional | | $95.50 | $177.83 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.17 / $131.83 / $281.84
| Facility | | $0.17 | $131.83 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $131.83 / $199.53
| Professional | | $89.13 | $131.83 | $199.53 |