- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $269.15 / $331.13
| Facility | | $173.78 | $269.15 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $229.09 / $616.60
| Professional | | $177.83 | $229.09 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $208.93 / $436.52
| Professional | | $177.83 | $208.93 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Professional | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $331.13 / $707.95
| Professional | | $213.80 | $331.13 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $154.88 / $512.86
| Facility | | $151.36 | $154.88 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $281.84 / $426.58
| Professional | | $218.78 | $281.84 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $269.15 / $537.03
| Professional | | $190.55 | $269.15 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $478.63
| Professional | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $331.13 / $616.60
| Professional | | $269.15 | $331.13 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $251.19 / $501.19
| Professional | | $158.49 | $251.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $269.15 / $562.34
| Professional | | $190.55 | $269.15 | $562.34 |