- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.78 / $228.79 / $754.87
| Facility | | $128.78 | $228.79 | $754.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.20 / $128.78 / $334.77
| Professional | | $82.20 | $128.78 | $334.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.85 / $219.20 / $566.00
| Facility | | $143.85 | $219.20 | $566.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.30 / $267.49 / $1,027.50
| Professional | | $123.30 | $267.49 | $1,027.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.33 / $220.84 / $353.75
| Facility | | $74.33 | $220.84 | $353.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.42 / $144.71 / $193.84
| Professional | | $65.42 | $144.71 | $193.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.00 / $171.25 / $468.75
| Facility | | $137.00 | $171.25 | $468.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.00 / $201.39 / $423.62
| Professional | | $137.00 | $201.39 | $423.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $134.12 / $145.37
| Professional | | $75.00 | $134.12 | $145.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.00 / $137.00 / $205.50
| Facility | | $137.00 | $137.00 | $205.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.00 / $239.75 / $411.00
| Facility | | $137.00 | $239.75 | $411.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.30 / $171.25 / $206.87
| Professional | | $123.30 | $171.25 | $206.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.85 / $219.20 / $376.75
| Facility | | $143.85 | $219.20 | $376.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.52 / $266.68 / $318.89
| Professional | | $151.52 | $266.68 | $318.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $57.54 / $153.44
| Professional | | $57.54 | $57.54 | $153.44 |