- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $323.59 / $630.96
| Professional | | $251.19 | $323.59 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $758.58 / $3,548.13
| Facility | | $660.69 | $758.58 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $537.03 / $758.58
| Professional | | $275.42 | $537.03 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $954.99 / $1,288.25
| Facility | | $794.33 | $954.99 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $676.08
| Professional | | $537.03 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $426.58 / $524.81
| Facility | | $371.54 | $426.58 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $398.11
| Professional | | $269.15 | $269.15 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $977.24
| Professional | | $645.65 | $645.65 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $426.58
| Facility | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $436.52
| Professional | | $426.58 | $426.58 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $758.58 / $3,548.13
| Facility | | $660.69 | $758.58 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $562.34 / $758.58
| Professional | | $275.42 | $562.34 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.44 / $354.81 / $758.58
| Facility | | $0.44 | $354.81 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $398.11 / $645.65
| Professional | | $263.03 | $398.11 | $645.65 |