- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.00 / $792.27 / $1,218.52
| Facility | | $236.00 | $792.27 | $1,218.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.82 / $236.00 / $400.12
| Professional | | $174.82 | $236.00 | $400.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.33 / $1,340.98 / $8,459.92
| Facility | | $1,006.33 | $1,340.98 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.26 / $227.26 / $227.26
| Professional | | $227.26 | $227.26 | $227.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.49 / $430.51 / $967.08
| Facility | | $276.49 | $430.51 | $967.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.97 / $268.39 / $505.16
| Professional | | $133.97 | $268.39 | $505.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.36 / $393.34 / $553.58
| Professional | | $173.36 | $393.34 | $553.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.40 / $696.47 / $847.77
| Facility | | $134.40 | $696.47 | $847.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.66 / $792.27 / $1,203.32
| Facility | | $247.66 | $792.27 | $1,203.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.78 / $247.66 / $1,203.32
| Professional | | $209.78 | $247.66 | $1,203.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.20 / $431.21 / $582.72
| Professional | | $279.20 | $431.21 | $582.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.68 / $484.72 / $967.08
| Facility | | $283.68 | $484.72 | $967.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.97 / $269.56 / $507.09
| Professional | | $133.97 | $269.56 | $507.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.36 / $291.36 / $320.50
| Facility | | $291.36 | $291.36 | $320.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.36 / $291.36 / $320.50
| Professional | | $291.36 | $291.36 | $320.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.37 / $122.37 / $122.37
| Facility | | $122.37 | $122.37 | $122.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.37 / $174.82 / $533.19
| Professional | | $122.37 | $174.82 | $533.19 |