- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.44 / $559.50 / $928.84
| Facility | | $281.44 | $559.50 | $928.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.44 / $307.70 / $318.95
| Professional | | $281.44 | $307.70 | $318.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,425.20 / $1,827.47 / $2,307.79
| Facility | | $1,425.20 | $1,827.47 | $2,307.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.80 / $131.80 / $223.66
| Professional | | $131.80 | $131.80 | $223.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.20 / $337.73 / $658.57
| Professional | | $300.20 | $337.73 | $658.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.91 / $698.19 / $1,922.34
| Facility | | $243.91 | $698.19 | $1,922.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.04 / $457.04 / $547.59
| Professional | | $457.04 | $457.04 | $547.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.25 / $450.30 / $555.37
| Professional | | $375.25 | $450.30 | $555.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.33 / $375.25 / $637.91
| Facility | | $298.33 | $375.25 | $637.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.00 / $743.00 / $900.60
| Professional | | $514.00 | $743.00 | $900.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.68 / $416.45 / $696.69
| Facility | | $262.68 | $416.45 | $696.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.68 / $426.66 / $696.69
| Professional | | $262.68 | $426.66 | $696.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.61 / $213.89 / $431.54
| Professional | | $157.61 | $213.89 | $431.54 |