- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.20 / $496.50 / $738.13
| Facility | | $397.20 | $496.50 | $738.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.87 / $314.45 / $496.50
| Professional | | $254.87 | $314.45 | $496.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.65 / $860.60 / $910.25
| Facility | | $711.65 | $860.60 | $910.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.40 / $184.15 / $1,350.24
| Professional | | $132.40 | $184.15 | $1,350.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.74 / $876.34 / $876.34
| Facility | | $840.74 | $876.34 | $876.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $911.03 / $1,064.60 / $1,633.14
| Facility | | $911.03 | $1,064.60 | $1,633.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.37 / $891.32 / $1,012.86
| Professional | | $380.37 | $891.32 | $1,012.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.87 / $397.20 / $1,158.50
| Facility | | $254.87 | $397.20 | $1,158.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.89 / $397.20 / $1,158.50
| Facility | | $297.89 | $397.20 | $1,158.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.49 / $198.60 / $1,020.75
| Professional | | $110.49 | $198.60 | $1,020.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $70.00 / $913.56
| Professional | | $50.00 | $70.00 | $913.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.87 / $397.20 / $1,158.50
| Facility | | $254.87 | $397.20 | $1,158.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.52 / $789.04 / $1,106.68
| Professional | | $352.52 | $789.04 | $1,106.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.00 / $1,572.25 / $1,572.25
| Facility | | $662.00 | $1,572.25 | $1,572.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.95 / $1,655.00 / $1,655.00
| Professional | | $479.95 | $1,655.00 | $1,655.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.22 / $139.22 / $704.88
| Professional | | $139.22 | $139.22 | $704.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.22 / $139.22 / $1,807.26
| Professional | | $139.22 | $139.22 | $1,807.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.77 / $198.60 / $595.79
| Professional | | $110.77 | $198.60 | $595.79 |