- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.83 / $277.83 / $277.83
| Facility | | $277.83 | $277.83 | $277.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.21 / $291.45 / $469.91
| Professional | | $222.21 | $291.45 | $469.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.18 / $288.64 / $498.81
| Professional | | $259.18 | $288.64 | $498.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.49 / $304.57 / $468.50
| Professional | | $293.49 | $304.57 | $468.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.08 / $333.08 / $333.08
| Facility | | $333.08 | $333.08 | $333.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.40 / $306.88 / $525.75
| Professional | | $237.40 | $306.88 | $525.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.39 / $642.39 / $642.39
| Facility | | $642.39 | $642.39 | $642.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.76 / $401.43 / $600.76
| Professional | | $292.76 | $401.43 | $600.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.12 / $346.88 / $455.84
| Professional | | $246.12 | $346.88 | $455.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.21 / $315.47 / $588.03
| Professional | | $222.21 | $315.47 | $588.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.89 / $256.89 / $256.89
| Facility | | $256.89 | $256.89 | $256.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.89 / $415.70 / $591.90
| Professional | | $256.89 | $415.70 | $591.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.08 / $333.08 / $333.08
| Facility | | $333.08 | $333.08 | $333.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.40 / $306.20 / $515.34
| Professional | | $237.40 | $306.20 | $515.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.02 / $286.02 / $286.02
| Facility | | $286.02 | $286.02 | $286.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.61 / $286.02 / $298.33
| Professional | | $233.61 | $286.02 | $298.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.64 / $255.91 / $411.57
| Professional | | $204.64 | $255.91 | $411.57 |