- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $223.87 / $707.95
| Facility | | $93.33 | $223.87 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $120.23 / $165.96
| Professional | | $93.33 | $120.23 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $112.20 / $194.98
| Facility | | $46.77 | $112.20 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $151.36 / $691.83
| Facility | | $102.33 | $151.36 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $229.09
| Professional | | $190.55 | $190.55 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,174.90 / $1,174.90
| Professional | | $776.25 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $158.49 / $295.12
| Facility | | $109.65 | $158.49 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $125.89 / $186.21
| Professional | | $93.33 | $125.89 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $169.82 / $331.13
| Professional | | $158.49 | $169.82 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $158.49 / $436.52
| Facility | | $93.33 | $158.49 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $165.96 / $275.42
| Professional | | $79.43 | $165.96 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $66.07 / $158.49
| Facility | | $56.23 | $66.07 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $66.07 / $107.15
| Professional | | $66.07 | $66.07 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $158.49 / $158.49
| Professional | | $7.94 | $158.49 | $158.49 |