- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.45 / $990.08 / $1,183.09
| Facility | | $240.45 | $990.08 | $1,183.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.73 / $229.13 / $240.45
| Professional | | $169.73 | $229.13 | $240.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.65 / $220.65 / $220.65
| Professional | | $220.65 | $220.65 | $220.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.39 / $367.52 / $845.25
| Facility | | $189.39 | $367.52 | $845.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,363.48 / $1,363.48 / $1,363.48
| Professional | | $1,363.48 | $1,363.48 | $1,363.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.02 / $381.89 / $698.71
| Professional | | $297.02 | $381.89 | $698.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.99 / $976.09 / $1,183.09
| Facility | | $314.99 | $976.09 | $1,183.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.65 / $240.45 / $1,168.29
| Professional | | $185.65 | $240.45 | $1,168.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.66 / $424.32 / $565.76
| Professional | | $418.66 | $424.32 | $565.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.11 / $357.64 / $938.83
| Facility | | $197.11 | $357.64 | $938.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,363.48 / $1,363.48 / $1,363.48
| Professional | | $1,363.48 | $1,363.48 | $1,363.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.88 / $282.88 / $311.17
| Facility | | $282.88 | $282.88 | $311.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.88 / $282.88 / $311.17
| Professional | | $282.88 | $282.88 | $311.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.81 / $118.81 / $118.81
| Facility | | $118.81 | $118.81 | $118.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.81 / $169.73 / $377.70
| Professional | | $118.81 | $169.73 | $377.70 |