- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.68 / $455.40 / $800.65
| Facility | | $141.68 | $455.40 | $800.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.08 / $141.68 / $237.96
| Professional | | $133.08 | $141.68 | $237.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.54 / $231.44 / $633.71
| Facility | | $149.54 | $231.44 | $633.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.44 / $202.40 / $802.64
| Professional | | $121.44 | $202.40 | $802.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.08 / $444.26 / $804.83
| Facility | | $289.08 | $444.26 | $804.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.26 / $190.26 / $190.26
| Professional | | $190.26 | $190.26 | $190.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.56 / $157.87 / $460.46
| Facility | | $131.56 | $157.87 | $460.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.21 / $213.59 / $527.76
| Professional | | $105.21 | $213.59 | $527.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.18 / $292.18 / $343.74
| Professional | | $292.18 | $292.18 | $343.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.40 / $202.40 / $626.80
| Professional | | $202.40 | $202.40 | $626.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.18 / $961.40 / $961.40
| Facility | | $352.18 | $961.40 | $961.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.44 / $121.44 / $1,012.00
| Professional | | $121.44 | $121.44 | $1,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.16 / $202.40 / $242.88
| Facility | | $182.16 | $202.40 | $242.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.01 / $121.44 / $361.50
| Professional | | $85.01 | $121.44 | $361.50 |