- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.37 / $218.06 / $497.64
| Facility | | $143.37 | $218.06 | $497.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.37 / $143.37 / $152.63
| Professional | | $143.37 | $143.37 | $152.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.03 / $255.63 / $525.48
| Facility | | $182.03 | $255.63 | $525.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.52 / $130.83 / $245.16
| Professional | | $94.52 | $130.83 | $245.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.55 / $222.65 / $1,251.68
| Facility | | $108.55 | $222.65 | $1,251.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.08 / $250.69 / $313.36
| Professional | | $228.08 | $250.69 | $313.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.31 / $128.66 / $307.30
| Professional | | $100.31 | $128.66 | $307.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $752.05 / $752.05 / $752.05
| Facility | | $752.05 | $752.05 | $752.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.59 / $163.55 / $386.29
| Professional | | $91.59 | $163.55 | $386.29 |