- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.47 / $157.47 / $1,284.22
| Facility | | $157.47 | $157.47 | $1,284.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.46 / $157.47 / $224.85
| Professional | | $157.46 | $157.47 | $224.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.35 / $772.34 / $1,120.91
| Facility | | $373.35 | $772.34 | $1,120.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.81 / $392.17 / $1,176.10
| Professional | | $244.81 | $392.17 | $1,176.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.16 / $527.32 / $665.50
| Facility | | $449.16 | $527.32 | $665.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.77 / $425.52 / $564.54
| Professional | | $308.77 | $425.52 | $564.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.04 / $351.99 / $889.09
| Facility | | $153.04 | $351.99 | $889.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.72 / $156.72 / $203.83
| Professional | | $156.72 | $156.72 | $203.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.10 / $271.10 / $271.10
| Facility | | $271.10 | $271.10 | $271.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.27 / $473.54 / $629.92
| Professional | | $250.27 | $473.54 | $629.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.30 / $369.63 / $393.90
| Facility | | $297.30 | $369.63 | $393.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.35 / $1,120.91 / $1,120.91
| Facility | | $373.35 | $1,120.91 | $1,120.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.29 / $367.22 / $1,176.10
| Professional | | $233.29 | $367.22 | $1,176.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.78 / $481.24 / $642.05
| Facility | | $401.78 | $481.24 | $642.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.55 / $337.55 / $725.35
| Professional | | $230.55 | $337.55 | $725.35 |