- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.73 / $306.77 / $383.46
| Professional | | $208.73 | $306.77 | $383.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.34 / $583.89 / $583.89
| Professional | | $59.34 | $583.89 | $583.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.00 / $234.00 / $234.00
| Facility | | $234.00 | $234.00 | $234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.90 / $198.90 / $966.09
| Professional | | $198.90 | $198.90 | $966.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.17 / $537.17 / $583.89
| Professional | | $537.17 | $537.17 | $583.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.68 / $313.62 / $449.46
| Professional | | $193.68 | $313.62 | $449.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.00 / $234.00 / $234.00
| Facility | | $234.00 | $234.00 | $234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.90 / $489.07 / $966.09
| Professional | | $198.90 | $489.07 | $966.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.47 / $555.76 / $555.76
| Professional | | $417.47 | $555.76 | $555.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.45 / $291.29 / $485.49
| Professional | | $224.45 | $291.29 | $485.49 |