- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.46 / $462.26 / $514.28
| Facility | | $58.46 | $462.26 | $514.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.46 / $58.46 / $259.88
| Professional | | $58.46 | $58.46 | $259.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.68 / $293.63 / $582.36
| Facility | | $159.68 | $293.63 | $582.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.25 / $168.75 / $669.20
| Professional | | $101.25 | $168.75 | $669.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.08 / $383.37 / $670.23
| Facility | | $268.08 | $383.37 | $670.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.04 / $28.04 / $28.04
| Professional | | $28.04 | $28.04 | $28.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $187.43 / $383.92
| Facility | | $104.71 | $187.43 | $383.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.59 / $162.01 / $440.25
| Professional | | $89.59 | $162.01 | $440.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.64 / $243.64 / $286.64
| Professional | | $243.64 | $243.64 | $286.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.75 / $168.75 / $522.60
| Professional | | $168.75 | $168.75 | $522.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.63 / $801.56 / $801.56
| Facility | | $293.63 | $801.56 | $801.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.25 / $101.25 / $843.75
| Professional | | $101.25 | $101.25 | $843.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.25 / $101.25 / $348.77
| Professional | | $101.25 | $101.25 | $348.77 |