- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $323.59 / $446.68
| Facility | | $173.78 | $323.59 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $158.49 / $338.84
| Professional | | $109.65 | $158.49 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $446.68 / $724.44
| Facility | | $162.18 | $446.68 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $154.88 / $323.59
| Professional | | $91.20 | $154.88 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $309.03 / $446.68
| Facility | | $251.19 | $309.03 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $120.23 / $245.47
| Facility | | $63.10 | $120.23 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $177.83 / $218.78
| Professional | | $93.33 | $177.83 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $263.03
| Professional | | $223.87 | $223.87 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $331.13
| Professional | | $154.88 | $154.88 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $165.96 / $223.87
| Facility | | $144.54 | $165.96 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $446.68 / $724.44
| Facility | | $162.18 | $446.68 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $154.88 / $323.59
| Professional | | $91.20 | $154.88 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $154.88 / $186.21
| Facility | | $85.11 | $154.88 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $114.82 / $269.15
| Professional | | $69.18 | $114.82 | $269.15 |