- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.66 / $590.58 / $814.95
| Professional | | $334.66 | $590.58 | $814.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.86 / $77.56 / $77.56
| Professional | | $55.86 | $77.56 | $77.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.72 / $422.72 / $855.50
| Facility | | $422.72 | $422.72 | $855.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.31 / $422.72 / $1,326.56
| Professional | | $359.31 | $422.72 | $1,326.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $122.31 / $200.00
| Professional | | $100.00 | $122.31 | $200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.34 / $116.34 / $155.12
| Professional | | $116.34 | $116.34 | $155.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.47 / $435.24 / $713.64
| Professional | | $335.47 | $435.24 | $713.64 |