- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.86 / $432.11 / $703.72
| Facility | | $201.86 | $432.11 | $703.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.57 / $134.57 / $209.88
| Professional | | $134.57 | $134.57 | $209.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $246.92 / $577.79
| Facility | | $55.00 | $246.92 | $577.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.92 / $32.49 / $254.37
| Professional | | $31.92 | $32.49 | $254.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.92 / $246.92 / $246.92
| Facility | | $246.92 | $246.92 | $246.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.25 / $246.92 / $246.92
| Professional | | $180.25 | $246.92 | $246.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.54 / $500.28 / $641.05
| Facility | | $172.54 | $500.28 | $641.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.73 / $354.66 / $1,190.15
| Professional | | $283.73 | $354.66 | $1,190.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.92 / $332.00 / $555.57
| Facility | | $246.92 | $332.00 | $555.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.77 / $145.68 / $461.74
| Professional | | $98.77 | $145.68 | $461.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.65 / $234.57 / $277.32
| Professional | | $154.65 | $234.57 | $277.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.75 / $523.97 / $641.05
| Facility | | $240.75 | $523.97 | $641.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.50 / $185.19 / $508.66
| Professional | | $160.50 | $185.19 | $508.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.71 / $135.81 / $358.03
| Professional | | $103.71 | $135.81 | $358.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.92 / $283.95 / $283.95
| Facility | | $246.92 | $283.95 | $283.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.65 / $246.92 / $296.77
| Professional | | $154.65 | $246.92 | $296.77 |