- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $8,912.51 / $52,480.75
| Facility | | $60.26 | $8,912.51 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $64.57 / $38,904.51
| Professional | | $58.88 | $64.57 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $63.10
| Facility | | $60.26 | $60.26 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $52.48 / $54.95
| Facility | | $52.48 | $52.48 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $52.48 / $52.48
| Professional | | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $89.13
| Facility | | $54.95 | $56.23 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $67.61
| Professional | | $60.26 | $60.26 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $75.86 / $208.93
| Facility | | $57.54 | $75.86 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $77.62
| Professional | | $58.88 | $58.88 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $61.66
| Facility | | $60.26 | $60.26 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $61.66 / $61.66
| Professional | | $60.26 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $72.44 / $83.18
| Facility | | $63.10 | $72.44 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $128.82 / $53,703.18
| Facility | | $64.57 | $128.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $63.10
| Professional | | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $60.26 / $72.44
| Professional | | $56.23 | $60.26 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $69.18
| Facility | | $60.26 | $60.26 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $61.66 / $61.66
| Professional | | $60.26 | $61.66 | $61.66 |