- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.78 / $253.36 / $102,595.18
| Facility | | $233.78 | $253.36 | $102,595.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.67 / $247.40 / $253.36
| Professional | | $205.67 | $247.40 | $253.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.67 / $255.84 / $255.84
| Facility | | $204.67 | $255.84 | $255.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.75 / $248.39 / $253.35
| Professional | | $216.75 | $248.39 | $253.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.39 / $248.39 / $253.36
| Facility | | $248.39 | $248.39 | $253.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.36 / $253.36 / $253.36
| Professional | | $253.36 | $253.36 | $253.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.84 / $325.63 / $637.11
| Facility | | $250.84 | $325.63 | $637.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.21 / $250.84 / $250.84
| Professional | | $213.21 | $250.84 | $250.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.36 / $263.29 / $263.29
| Facility | | $253.36 | $263.29 | $263.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.36 / $253.36 / $263.29
| Professional | | $253.36 | $253.36 | $263.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.58 / $288.81 / $440.54
| Facility | | $242.58 | $288.81 | $440.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.39 / $253.36 / $597.00
| Facility | | $248.39 | $253.36 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.36 / $253.36 / $253.36
| Professional | | $253.36 | $253.36 | $253.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.39 / $248.39 / $370.10
| Professional | | $248.39 | $248.39 | $370.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.36 / $253.36 / $253.36
| Facility | | $253.36 | $253.36 | $253.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.36 / $253.36 / $263.29
| Professional | | $253.36 | $253.36 | $263.29 |