- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.51 / $579.78 / $1,144.50
| Facility | | $377.51 | $579.78 | $1,144.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $381.30 / $788.46
| Professional | | $377.52 | $381.30 | $788.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.13 / $409.57 / $8,639.91
| Facility | | $348.13 | $409.57 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.77 / $391.77 / $391.77
| Professional | | $391.77 | $391.77 | $391.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.15 / $377.52 / $377.52
| Facility | | $356.15 | $377.52 | $377.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $377.52 / $377.52
| Professional | | $377.52 | $377.52 | $377.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $931.11 / $931.11 / $1,353.04
| Facility | | $931.11 | $931.11 | $1,353.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.24 / $642.61 / $1,144.50
| Facility | | $380.24 | $642.61 | $1,144.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $413.00 / $1,144.50
| Professional | | $377.52 | $413.00 | $1,144.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.15 / $377.52 / $377.52
| Facility | | $356.15 | $377.52 | $377.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $377.52 / $377.52
| Professional | | $377.52 | $377.52 | $377.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.86 / $340.86 / $395.53
| Facility | | $340.86 | $340.86 | $395.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.86 / $340.86 / $395.53
| Professional | | $340.86 | $340.86 | $395.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.48 / $376.48 / $459.31
| Facility | | $376.48 | $376.48 | $459.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $400.17 / $650.66
| Professional | | $377.52 | $400.17 | $650.66 |