- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.91 / $596.02 / $766.38
| Facility | | $139.91 | $596.02 | $766.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.90 / $139.91 / $1,110.65
| Professional | | $122.90 | $139.91 | $1,110.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.63 / $937.62 / $8,459.92
| Facility | | $703.63 | $937.62 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.72 / $134.72 / $134.72
| Professional | | $134.72 | $134.72 | $134.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.91 / $255.40 / $573.73
| Facility | | $163.91 | $255.40 | $573.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.48 / $184.58 / $391.03
| Professional | | $87.48 | $184.58 | $391.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.77 / $233.19 / $328.19
| Professional | | $102.77 | $233.19 | $328.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.27 / $581.70 / $610.69
| Facility | | $259.27 | $581.70 | $610.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.82 / $513.87 / $766.38
| Facility | | $146.82 | $513.87 | $766.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.37 / $146.82 / $713.38
| Professional | | $124.37 | $146.82 | $713.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.64 / $259.10 / $345.46
| Professional | | $255.64 | $259.10 | $345.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.13 / $287.36 / $573.73
| Facility | | $168.13 | $287.36 | $573.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.94 / $188.67 / $391.03
| Professional | | $90.94 | $188.67 | $391.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.73 / $172.73 / $225.79
| Facility | | $172.73 | $172.73 | $225.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.73 / $172.73 / $225.79
| Professional | | $172.73 | $172.73 | $225.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.55 / $103.64 / $259.10
| Professional | | $72.55 | $103.64 | $259.10 |