- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.95 / $198.95 / $769.94
| Facility | | $198.95 | $198.95 | $769.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.17 / $232.81 / $276.52
| Professional | | $189.17 | $232.81 | $276.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.10 / $483.41 / $483.41
| Professional | | $368.10 | $483.41 | $483.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.81 / $312.81 / $483.41
| Facility | | $312.81 | $312.81 | $483.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.35 / $228.35 / $423.29
| Professional | | $228.35 | $228.35 | $423.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.74 / $483.41 / $918.48
| Professional | | $444.74 | $483.41 | $918.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.56 / $386.73 / $410.90
| Professional | | $362.56 | $386.73 | $410.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.95 / $198.95 / $769.94
| Facility | | $198.95 | $198.95 | $769.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.17 / $257.99 / $305.64
| Professional | | $189.17 | $257.99 | $305.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.50 / $212.20 / $952.40
| Professional | | $161.50 | $212.20 | $952.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.81 / $312.81 / $483.41
| Facility | | $312.81 | $312.81 | $483.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.35 / $228.35 / $574.13
| Professional | | $228.35 | $228.35 | $574.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.50 / $460.12 / $460.12
| Facility | | $309.50 | $460.12 | $460.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.50 / $460.12 / $471.36
| Professional | | $309.50 | $460.12 | $471.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.04 / $242.17 / $435.92
| Professional | | $185.04 | $242.17 | $435.92 |