- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $457.09
| Facility | | $338.84 | $338.84 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $181.97 / $501.19
| Professional | | $102.33 | $181.97 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $831.76
| Facility | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $208.93 / $1,047.13
| Professional | | $104.71 | $208.93 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $194.98
| Facility | | $72.44 | $72.44 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $263.03 / $398.11
| Professional | | $151.36 | $263.03 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $128.82 / $316.23
| Professional | | $70.79 | $128.82 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Facility | | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $223.87 / $323.59
| Professional | | $173.78 | $223.87 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $257.04 / $407.38
| Professional | | $144.54 | $257.04 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Professional | | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $831.76
| Facility | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $208.93 / $1,047.13
| Professional | | $114.82 | $208.93 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $229.09 / $239.88
| Facility | | $91.20 | $229.09 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $190.55 / $389.05
| Professional | | $97.72 | $190.55 | $389.05 |