- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.40 / $320.50 / $454.53
| Facility | | $241.40 | $320.50 | $454.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.04 / $265.00 / $394.45
| Professional | | $228.04 | $265.00 | $394.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.07 / $255.09 / $455.12
| Professional | | $204.07 | $255.09 | $455.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.24 / $360.24 / $360.24
| Facility | | $360.24 | $360.24 | $360.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.24 / $360.24 / $368.36
| Professional | | $360.24 | $360.24 | $368.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.69 / $404.69 / $404.69
| Facility | | $404.69 | $404.69 | $404.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.03 / $384.40 / $872.15
| Professional | | $191.03 | $384.40 | $872.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.65 / $277.95 / $625.39
| Facility | | $103.65 | $277.95 | $625.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.39 / $346.67 / $518.79
| Professional | | $265.39 | $346.67 | $518.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.17 / $320.37 / $581.91
| Professional | | $197.17 | $320.37 | $581.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.91 / $303.75 / $596.24
| Professional | | $289.91 | $303.75 | $596.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.69 / $404.69 / $597.00
| Facility | | $404.69 | $404.69 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.55 / $380.11 / $842.55
| Professional | | $214.55 | $380.11 | $842.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.76 / $306.98 / $718.52
| Professional | | $229.76 | $306.98 | $718.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.81 / $290.81 / $363.16
| Facility | | $290.81 | $290.81 | $363.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.17 / $333.18 / $632.50
| Professional | | $197.17 | $333.18 | $632.50 |