- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.63 / $275.63 / $365.93
| Professional | | $151.63 | $275.63 | $365.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.85 / $293.85 / $444.41
| Professional | | $293.85 | $293.85 | $444.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.15 / $241.06 / $321.42
| Facility | | $32.15 | $241.06 | $321.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $241.06 / $321.42
| Professional | | $32.15 | $241.06 | $321.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.45 / $263.45 / $325.44
| Facility | | $263.45 | $263.45 | $325.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.93 / $263.45 / $438.75
| Professional | | $223.93 | $263.45 | $438.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $332.00 / $332.00
| Facility | | $319.00 | $332.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.12 / $246.04 / $378.53
| Professional | | $206.12 | $246.04 | $378.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.53 / $259.82 / $290.38
| Professional | | $244.53 | $259.82 | $290.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.68 / $297.68 / $297.68
| Professional | | $297.68 | $297.68 | $297.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.45 / $263.45 / $325.44
| Facility | | $263.45 | $263.45 | $325.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.93 / $227.69 / $438.75
| Professional | | $223.93 | $227.69 | $438.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.98 / $215.33 / $314.30
| Professional | | $126.98 | $215.33 | $314.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.53 / $244.53 / $244.53
| Facility | | $244.53 | $244.53 | $244.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.53 / $244.53 / $290.38
| Professional | | $244.53 | $244.53 | $290.38 |