- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $389.05 / $630.96
| Facility | | $141.25 | $389.05 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $138.04 / $660.69
| Professional | | $109.65 | $138.04 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $208.93 / $707.95
| Facility | | $134.90 | $208.93 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $147.91 / $316.23
| Professional | | $61.66 | $147.91 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $363.08 / $575.44
| Facility | | $288.40 | $363.08 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $190.55
| Professional | | $138.04 | $138.04 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $234.42 / $575.44
| Facility | | $114.82 | $234.42 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $181.97 / $245.47
| Professional | | $93.33 | $181.97 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $3,630.78 / $9,772.37
| Facility | | $83.18 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $251.19
| Professional | | $213.80 | $213.80 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $147.91 / $446.68
| Professional | | $147.91 | $147.91 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $208.93 / $707.95
| Facility | | $134.90 | $208.93 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $147.91 / $316.23
| Professional | | $70.79 | $147.91 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $147.91 / $239.88
| Facility | | $85.11 | $147.91 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $123.03 / $354.81
| Professional | | $29.51 | $123.03 | $354.81 |