- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.97 / $372.53 / $572.97
| Facility | | $110.97 | $372.53 | $572.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.20 / $110.97 / $880.91
| Professional | | $82.20 | $110.97 | $880.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.18 / $630.54 / $8,459.92
| Facility | | $473.18 | $630.54 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.86 / $106.86 / $106.86
| Professional | | $106.86 | $106.86 | $106.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.01 / $202.19 / $454.20
| Facility | | $130.01 | $202.19 | $454.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.01 / $126.22 / $237.57
| Professional | | $63.01 | $126.22 | $237.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.52 / $184.95 / $260.30
| Professional | | $81.52 | $184.95 | $260.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.45 / $372.53 / $565.80
| Facility | | $116.45 | $372.53 | $565.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.16 / $116.45 / $565.80
| Professional | | $93.16 | $116.45 | $565.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.76 / $205.50 / $389.60
| Professional | | $202.76 | $205.50 | $389.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.49 / $227.92 / $454.20
| Facility | | $133.49 | $227.92 | $454.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.01 / $126.77 / $238.48
| Professional | | $63.01 | $126.77 | $238.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.00 / $137.00 / $150.69
| Facility | | $137.00 | $137.00 | $150.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.00 / $137.00 / $150.69
| Professional | | $137.00 | $137.00 | $150.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $82.20 / $250.71
| Professional | | $57.54 | $82.20 | $250.71 |