- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.38 / $361.36 / $588.83
| Professional | | $210.38 | $361.36 | $588.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.44 / $473.44 / $619.02
| Professional | | $473.44 | $473.44 | $619.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.75 / $51.75 / $672.75
| Facility | | $51.75 | $51.75 | $672.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.75 / $51.75 / $672.75
| Professional | | $51.75 | $51.75 | $672.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.73 / $283.73 / $423.43
| Facility | | $283.73 | $283.73 | $423.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.17 / $283.73 / $423.43
| Professional | | $241.17 | $283.73 | $423.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.11 / $487.64 / $487.64
| Professional | | $390.11 | $487.64 | $487.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.76 / $463.00 / $487.64
| Professional | | $435.76 | $463.00 | $487.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.88 / $541.88 / $541.88
| Professional | | $541.88 | $541.88 | $541.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.73 / $283.73 / $423.43
| Facility | | $283.73 | $283.73 | $423.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.17 / $283.73 / $423.43
| Professional | | $241.17 | $283.73 | $423.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.34 / $346.91 / $554.47
| Professional | | $204.34 | $346.91 | $554.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.76 / $435.76 / $435.76
| Facility | | $435.76 | $435.76 | $435.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.76 / $435.76 / $487.64
| Professional | | $435.76 | $435.76 | $487.64 |