- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.83 / $149.83 / $149.83
| Facility | | $149.83 | $149.83 | $149.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.83 / $149.83 / $172.30
| Professional | | $149.83 | $149.83 | $172.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.38 / $352.54 / $468.43
| Facility | | $141.38 | $352.54 | $468.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.38 / $166.13 / $180.93
| Professional | | $141.38 | $166.13 | $180.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.14 / $224.92 / $479.45
| Facility | | $189.14 | $224.92 | $479.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.66 / $164.66 / $164.66
| Facility | | $164.66 | $164.66 | $164.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.66 / $164.66 / $164.66
| Professional | | $164.66 | $164.66 | $164.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.09 / $90.09 / $105.98
| Professional | | $90.09 | $90.09 | $105.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.36 / $149.83 / $311.17
| Professional | | $127.36 | $149.83 | $311.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.02
| Facility | | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.46 / $167.46 / $352.54
| Facility | | $167.46 | $167.46 | $352.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.02 / $176.27 / $220.53
| Professional | | $147.02 | $176.27 | $220.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.02 / $176.27 / $205.83
| Professional | | $147.02 | $176.27 | $205.83 |