- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.46 / $420.43 / $453.05
| Facility | | $188.46 | $420.43 | $453.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.21 / $188.47 / $212.74
| Professional | | $181.21 | $188.47 | $212.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.37 / $220.13 / $574.29
| Facility | | $175.37 | $220.13 | $574.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.22 / $181.22 / $181.22
| Professional | | $181.22 | $181.22 | $181.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.22 / $181.22 / $181.22
| Facility | | $181.22 | $181.22 | $181.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.22 / $181.22 / $181.22
| Professional | | $181.22 | $181.22 | $181.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.22 / $181.22 / $219.46
| Professional | | $181.22 | $181.22 | $219.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.43 / $420.43 / $453.05
| Facility | | $420.43 | $420.43 | $453.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.21 / $201.33 / $367.51
| Professional | | $181.21 | $201.33 | $367.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.22 / $181.22 / $271.83
| Professional | | $181.22 | $181.22 | $271.83 |