- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $346.74 / $15,848.93
| Facility | | $199.53 | $346.74 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $204.17 / $588.84
| Professional | | $199.53 | $204.17 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $467.74 / $630.96
| Facility | | $208.93 | $467.74 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $199.53 / $269.15
| Professional | | $186.21 | $199.53 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $398.11
| Facility | | $199.53 | $199.53 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Facility | | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Professional | | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $323.59 / $8,511.38
| Facility | | $199.53 | $323.59 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $346.74
| Professional | | $186.21 | $186.21 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $6,606.93 / $9,772.37
| Facility | | $6,606.93 | $6,606.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $467.74 / $630.96
| Facility | | $208.93 | $467.74 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $199.53 / $269.15
| Professional | | $186.21 | $199.53 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $426.58
| Facility | | $398.11 | $398.11 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $204.17 / $436.52
| Facility | | $199.53 | $204.17 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $208.93 / $295.12
| Professional | | $194.98 | $208.93 | $295.12 |