- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $234.42 / $234.42
| Facility | | $199.53 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $158.49 / $223.87
| Professional | | $131.83 | $158.49 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $234.42 / $812.83
| Professional | | $151.36 | $234.42 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $537.03 / $851.14
| Facility | | $457.09 | $537.03 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $354.81 / $676.08
| Professional | | $165.96 | $354.81 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $186.21 / $295.12
| Facility | | $123.03 | $186.21 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $371.54 / $416.87
| Professional | | $213.80 | $371.54 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $194.98 / $338.84
| Facility | | $134.90 | $194.98 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $309.03 / $1,023.29
| Professional | | $162.18 | $309.03 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $64.57 / $165.96
| Professional | | $32.36 | $64.57 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $398.11 / $549.54
| Professional | | $204.17 | $398.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,023.29 / $1,023.29
| Facility | | $363.08 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $812.83 / $1,023.29
| Professional | | $208.93 | $812.83 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $426.58
| Professional | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $1,047.13 / $1,318.26
| Professional | | $467.74 | $1,047.13 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $245.47 / $588.84
| Professional | | $162.18 | $245.47 | $588.84 |