- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.46 / $339.46 / $339.46
| Facility | | $339.46 | $339.46 | $339.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.82 / $265.91 / $339.46
| Professional | | $217.82 | $265.91 | $339.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.90 / $228.90 / $1,211.63
| Professional | | $228.90 | $228.90 | $1,211.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.67 / $430.67 / $430.67
| Facility | | $430.67 | $430.67 | $430.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $778.57 / $909.82 / $1,395.68
| Facility | | $778.57 | $909.82 | $1,395.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.21 / $761.74 / $865.61
| Professional | | $335.21 | $761.74 | $865.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.82 / $339.46 / $990.08
| Facility | | $217.82 | $339.46 | $990.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.82 / $339.46 / $990.08
| Facility | | $217.82 | $339.46 | $990.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.44 / $169.73 / $872.36
| Professional | | $141.44 | $169.73 | $872.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $70.00 / $85.00
| Professional | | $50.00 | $70.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.82 / $339.46 / $990.08
| Facility | | $217.82 | $339.46 | $990.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.50 / $674.89 / $946.58
| Professional | | $472.50 | $674.89 | $946.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.76 / $1,343.68 / $1,343.68
| Facility | | $565.76 | $1,343.68 | $1,343.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,131.52 / $1,131.52 / $1,408.74
| Professional | | $1,131.52 | $1,131.52 | $1,408.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.41 / $602.41 / $602.41
| Professional | | $602.41 | $602.41 | $602.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.11 / $1,544.52 / $1,544.52
| Professional | | $822.11 | $1,544.52 | $1,544.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.30 / $169.73 / $526.54
| Professional | | $127.30 | $169.73 | $526.54 |