- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $616.60 / $891.25
| Facility | | $190.55 | $616.60 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $223.87 / $691.83
| Professional | | $181.97 | $223.87 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $316.23 / $954.99
| Facility | | $204.17 | $316.23 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $1,023.29
| Professional | | $165.96 | $275.42 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $346.74 / $549.54
| Facility | | $275.42 | $346.74 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $269.15
| Professional | | $257.04 | $257.04 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $213.80 / $436.52
| Facility | | $194.98 | $213.80 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $263.03 / $537.03
| Professional | | $165.96 | $263.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $3,630.78 / $9,772.37
| Facility | | $83.18 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $467.74
| Professional | | $398.11 | $398.11 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $457.09
| Professional | | $275.42 | $275.42 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $3,019.95
| Facility | | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $316.23 / $954.99
| Facility | | $204.17 | $316.23 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $1,023.29
| Professional | | $165.96 | $275.42 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $331.13
| Facility | | $165.96 | $275.42 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $489.78
| Professional | | $165.96 | $275.42 | $489.78 |