- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $389.05 / $549.54
| Facility | | $123.03 | $389.05 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $141.25 / $436.52
| Professional | | $114.82 | $141.25 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $199.53 / $602.56
| Facility | | $128.82 | $199.53 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $660.69
| Professional | | $104.71 | $173.78 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $346.74 / $501.19
| Facility | | $275.42 | $346.74 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $165.96
| Professional | | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $138.04 / $338.84
| Facility | | $114.82 | $138.04 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $208.93 / $436.52
| Professional | | $95.50 | $208.93 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $295.12
| Professional | | $251.19 | $251.19 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $371.54
| Professional | | $173.78 | $173.78 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $199.53 / $602.56
| Facility | | $128.82 | $199.53 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $660.69
| Professional | | $104.71 | $173.78 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $208.93
| Facility | | $104.71 | $173.78 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $338.84
| Professional | | $104.71 | $173.78 | $338.84 |