- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.44 / $345.20 / $951.12
| Facility | | $146.44 | $345.20 | $951.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.10 / $147.22 / $147.22
| Professional | | $120.10 | $147.22 | $147.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.58 / $246.92 / $246.92
| Professional | | $161.58 | $246.92 | $246.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.92 / $246.92 / $246.92
| Facility | | $246.92 | $246.92 | $246.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.50 / $386.28 / $863.62
| Facility | | $131.50 | $386.28 | $863.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $236.24 / $354.66
| Professional | | $102.67 | $236.24 | $354.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.20 / $1,172.86 / $1,172.86
| Facility | | $385.20 | $1,172.86 | $1,172.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.85 / $246.92 / $259.27
| Facility | | $127.85 | $246.92 | $259.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.88 / $246.92 / $246.92
| Professional | | $209.88 | $246.92 | $246.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.58 / $246.92 / $355.07
| Facility | | $131.58 | $246.92 | $355.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $190.13 / $216.94
| Professional | | $102.67 | $190.13 | $216.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.36 / $86.36 / $123.38
| Professional | | $81.36 | $86.36 | $123.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.77 / $75.55 / $246.92
| Professional | | $45.77 | $75.55 | $246.92 |