- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.63 / $294.47 / $527.82
| Facility | | $129.63 | $294.47 | $527.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.16 / $121.77 / $157.41
| Professional | | $98.16 | $121.77 | $157.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.14 / $228.90 / $482.98
| Professional | | $199.14 | $228.90 | $482.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.20 / $185.20 / $185.20
| Facility | | $185.20 | $185.20 | $185.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.19 / $185.20 / $185.20
| Professional | | $135.19 | $185.20 | $185.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.24 / $391.24 / $480.80
| Facility | | $222.24 | $391.24 | $480.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.89 / $892.66 / $892.66
| Professional | | $225.89 | $892.66 | $892.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.20 / $314.83 / $416.70
| Facility | | $185.20 | $314.83 | $416.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.46 / $244.46 / $401.88
| Professional | | $194.46 | $244.46 | $401.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.41 / $185.20 / $335.82
| Professional | | $157.41 | $185.20 | $335.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.24 / $452.07 / $555.00
| Facility | | $222.24 | $452.07 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.38 / $138.90 / $425.96
| Professional | | $120.38 | $138.90 | $425.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.78 / $102.91 / $277.80
| Professional | | $77.78 | $102.91 | $277.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.20 / $212.98 / $212.98
| Facility | | $185.20 | $212.98 | $212.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.41 / $185.20 / $222.59
| Professional | | $157.41 | $185.20 | $222.59 |