- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.22 / $259.88 / $428.45
| Professional | | $169.22 | $259.88 | $428.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.62 / $327.62 / $409.53
| Professional | | $327.62 | $327.62 | $409.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.06 / $37.06 / $481.78
| Facility | | $37.06 | $37.06 | $481.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.06 / $37.06 / $481.78
| Professional | | $37.06 | $37.06 | $481.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.92 / $219.78 / $219.78
| Facility | | $38.92 | $219.78 | $219.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.92 / $186.81 / $517.50
| Professional | | $38.92 | $186.81 | $517.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.63 / $301.54 / $320.39
| Professional | | $295.63 | $301.54 | $320.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.92 / $219.78 / $219.78
| Facility | | $38.92 | $219.78 | $219.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.92 / $186.81 / $517.50
| Professional | | $38.92 | $186.81 | $517.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.91 / $256.67 / $407.01
| Professional | | $164.91 | $256.67 | $407.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.54 / $301.54 / $301.54
| Facility | | $301.54 | $301.54 | $301.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.54 / $301.54 / $320.39
| Professional | | $301.54 | $301.54 | $320.39 |