- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.58 / $330.22 / $330.22
| Facility | | $324.58 | $330.22 | $330.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.77 / $281.48 / $333.37
| Professional | | $260.77 | $281.48 | $333.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.29 / $178.29 / $301.54
| Professional | | $178.29 | $178.29 | $301.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.11 / $206.30 / $206.30
| Facility | | $205.11 | $206.30 | $206.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.85 / $216.62 / $266.64
| Professional | | $194.85 | $216.62 | $266.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.70 / $358.15 / $505.75
| Professional | | $22.70 | $358.15 | $505.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.77 / $251.77 / $330.22
| Facility | | $251.77 | $251.77 | $330.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.77 / $281.48 / $333.37
| Professional | | $251.77 | $281.48 | $333.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $55.00
| Professional | | $30.00 | $30.00 | $55.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.47 / $258.47 / $258.47
| Professional | | $258.47 | $258.47 | $258.47 |