- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.52 / $193.25 / $1,731.72
| Facility | | $150.52 | $193.25 | $1,731.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.52 / $150.52 / $1,242.59
| Professional | | $150.52 | $150.52 | $1,242.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.14 / $393.57 / $952.72
| Facility | | $198.14 | $393.57 | $952.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.30 / $170.01 / $416.30
| Professional | | $77.30 | $170.01 | $416.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $139.72 / $544.97
| Facility | | $92.60 | $139.72 | $544.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.72 / $128.16 / $474.42
| Professional | | $89.72 | $128.16 | $474.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.68 / $334.12 / $646.89
| Facility | | $131.68 | $334.12 | $646.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.30 / $131.31 / $562.01
| Professional | | $103.30 | $131.31 | $562.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.60 / $193.25 / $260.89
| Professional | | $154.60 | $193.25 | $260.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.93 / $222.24 / $393.93
| Professional | | $173.93 | $222.24 | $393.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.26 / $917.94 / $917.94
| Facility | | $336.26 | $917.94 | $917.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.25 / $966.25 / $1,449.38
| Professional | | $966.25 | $966.25 | $1,449.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.91 / $231.91 / $231.91
| Professional | | $231.91 | $231.91 | $231.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.52 / $231.90 / $555.32
| Facility | | $150.52 | $231.90 | $555.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.53 / $222.24 / $443.96
| Professional | | $113.53 | $222.24 | $443.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.30 / $678.30 / $678.30
| Professional | | $678.30 | $678.30 | $678.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.60 / $173.93 / $262.82
| Professional | | $154.60 | $173.93 | $262.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.17 / $193.25 / $193.25
| Facility | | $81.17 | $193.25 | $193.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.17 / $83.73 / $371.23
| Professional | | $81.17 | $83.73 | $371.23 |