- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.56 / $370.37 / $897.51
| Facility | | $234.56 | $370.37 | $897.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.25 / $312.89 / $527.10
| Professional | | $211.25 | $312.89 | $527.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.04 / $760.66 / $1,020.68
| Facility | | $298.04 | $760.66 | $1,020.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.60 / $315.79 / $372.35
| Professional | | $274.60 | $315.79 | $372.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.74 / $399.26 / $851.09
| Facility | | $335.74 | $399.26 | $851.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.55 / $307.55 / $307.55
| Facility | | $307.55 | $307.55 | $307.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.55 / $307.55 / $307.55
| Professional | | $307.55 | $307.55 | $307.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.89 / $494.38 / $8,090.00
| Facility | | $312.89 | $494.38 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.95 / $312.89 / $649.83
| Professional | | $265.95 | $312.89 | $649.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.95 / $785.43 / $1,787.76
| Facility | | $279.95 | $785.43 | $1,787.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.47 / $339.47 / $658.74
| Facility | | $339.47 | $339.47 | $658.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.60 / $334.54 / $411.90
| Professional | | $274.60 | $334.54 | $411.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.18 / $514.55 / $701.64
| Facility | | $279.18 | $514.55 | $701.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.00 / $361.52 / $444.41
| Professional | | $304.00 | $361.52 | $444.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.60 / $334.54 / $384.45
| Professional | | $274.60 | $334.54 | $384.45 |