- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.59 / $445.45 / $445.45
| Facility | | $421.59 | $445.45 | $445.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.67 / $335.18 / $565.89
| Professional | | $229.67 | $335.18 | $565.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.04 / $419.04 / $650.29
| Facility | | $419.04 | $419.04 | $650.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.04 / $743.25 / $929.06
| Professional | | $419.04 | $743.25 | $929.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.48 / $549.39 / $641.10
| Professional | | $508.48 | $549.39 | $641.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.38 / $757.27 / $2,961.69
| Facility | | $371.38 | $757.27 | $2,961.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.93 / $314.54 / $807.71
| Professional | | $275.93 | $314.54 | $807.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.39 / $650.29 / $847.80
| Facility | | $648.39 | $650.29 | $847.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.61 / $768.53 / $1,242.71
| Professional | | $532.61 | $768.53 | $1,242.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.93 / $294.93 / $775.42
| Professional | | $275.93 | $294.93 | $775.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.36 / $579.36 / $579.36
| Facility | | $579.36 | $579.36 | $579.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.69 / $579.36 / $579.36
| Professional | | $457.69 | $579.36 | $579.36 |