- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $144.54 / $144.54
| Facility | | $125.89 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $144.54 / $316.23
| Professional | | $104.71 | $144.54 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $85.11 / $154.88 / $776.25
| Professional | 50 | $85.11 | $154.88 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $741.31 / $2,137.96
| Facility | | $467.74 | $741.31 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $707.95 / $1,258.93 / $3,162.28
| Facility | 50 | $707.95 | $1,258.93 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $275.42 / $446.68
| Professional | | $190.55 | $275.42 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $275.42 / $416.87 / $645.65
| Professional | 50 | $275.42 | $416.87 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $1,202.26
| Facility | | $354.81 | $501.19 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $371.54 / $602.56
| Professional | | $223.87 | $371.54 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $933.25
| Facility | | $389.05 | $478.63 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $338.84 / $537.03
| Professional | | $234.42 | $338.84 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $218.78 / $389.05
| Facility | | $117.49 | $218.78 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $239.88 / $239.88 / $4,073.80
| Facility | 50 | $239.88 | $239.88 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $245.47 / $870.96
| Professional | | $128.82 | $245.47 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $380.19 / $426.58 / $851.14
| Professional | 50 | $380.19 | $426.58 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,862.09 / $3,715.35
| Facility | | $812.83 | $1,862.09 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $218.78 / $436.52
| Professional | | $128.82 | $218.78 | $436.52 |