- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $371.54 / $537.03
| Facility | | $141.25 | $371.54 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $141.25 / $173.78
| Professional | | $109.65 | $141.25 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Facility | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $120.23 / $812.83
| Professional | | $97.72 | $120.23 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $398.11 / $575.44
| Facility | | $323.59 | $398.11 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Professional | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $134.90 / $263.03
| Facility | | $120.23 | $134.90 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $199.53 / $239.88
| Professional | | $107.15 | $199.53 | $239.88 |
- 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
- $234.42 / $234.42 / $275.42
| Professional | | $234.42 | $234.42 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $354.81
| Professional | | $162.18 | $162.18 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Facility | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $120.23 / $812.83
| Professional | | $97.72 | $120.23 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $162.18 / $245.47
| Facility | | $120.23 | $162.18 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $162.18 / $346.74
| Professional | | $97.72 | $162.18 | $346.74 |