- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.98 / $369.13 / $719.33
| Facility | | $238.98 | $369.13 | $719.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.62 / $236.62 / $286.31
| Professional | | $236.62 | $236.62 | $286.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.15 / $256.70 / $8,459.92
| Facility | | $219.15 | $256.70 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.54 / $245.54 / $245.54
| Professional | | $245.54 | $245.54 | $245.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.22 / $236.62 / $236.62
| Facility | | $223.22 | $236.62 | $236.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.62 / $236.62 / $245.54
| Professional | | $236.62 | $236.62 | $245.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.54 / $256.70 / $295.99
| Professional | | $245.54 | $256.70 | $295.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.95 / $611.95 / $611.95
| Facility | | $611.95 | $611.95 | $611.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.98 / $358.47 / $719.33
| Facility | | $238.98 | $358.47 | $719.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.62 / $238.98 / $538.10
| Professional | | $236.62 | $238.98 | $538.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $390.60 / $475.00
| Professional | | $27.40 | $390.60 | $475.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.22 / $236.62 / $236.62
| Facility | | $223.22 | $236.62 | $236.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.62 / $236.62 / $251.78
| Professional | | $236.62 | $236.62 | $251.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.43 / $217.43 / $252.30
| Facility | | $217.43 | $217.43 | $252.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.43 / $217.43 / $252.30
| Professional | | $217.43 | $217.43 | $252.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.62 / $250.82 / $321.33
| Professional | | $236.62 | $250.82 | $321.33 |