- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.06 / $450.06 / $692.19
| Facility | | $134.06 | $450.06 | $692.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.10 / $134.06 / $1,064.23
| Professional | | $100.10 | $134.06 | $1,064.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.07 / $763.65 / $8,459.92
| Facility | | $573.07 | $763.65 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.10 / $129.10 / $129.10
| Professional | | $129.10 | $129.10 | $129.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.07 / $244.28 / $548.73
| Facility | | $157.07 | $244.28 | $548.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.19 / $176.61 / $373.99
| Professional | | $76.19 | $176.61 | $373.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.48 / $223.44 / $314.47
| Professional | | $98.48 | $223.44 | $314.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.32 / $333.32 / $521.41
| Facility | | $333.32 | $333.32 | $521.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.68 / $453.12 / $683.56
| Facility | | $140.68 | $453.12 | $683.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.55 / $140.68 / $683.56
| Professional | | $112.55 | $140.68 | $683.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.95 / $248.26 / $331.02
| Professional | | $244.95 | $248.26 | $331.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.19 / $275.35 / $548.73
| Facility | | $161.19 | $275.35 | $548.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.61 / $177.01 / $373.99
| Professional | | $77.61 | $177.01 | $373.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.51 / $165.51 / $183.89
| Facility | | $165.51 | $165.51 | $183.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.51 / $165.51 / $183.89
| Professional | | $165.51 | $165.51 | $183.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.96 / $198.61 / $198.61
| Facility | | $148.96 | $198.61 | $198.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.51 / $99.31 / $231.71
| Professional | | $69.51 | $99.31 | $231.71 |