- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.36 / $322.89 / $369.94
| Facility | | $291.36 | $322.89 | $369.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.70 / $341.82 / $615.77
| Professional | | $267.70 | $341.82 | $615.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.71 / $408.71 / $408.71
| Facility | | $408.71 | $408.71 | $408.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.36 / $298.36 / $420.97
| Professional | | $298.36 | $298.36 | $420.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.60 / $99,999.99 / $99,999.99
| Facility | | $243.60 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.08 / $494.19 / $703.22
| Professional | | $317.08 | $494.19 | $703.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.95 / $312.24 / $343.46
| Professional | | $202.95 | $312.24 | $343.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.57 / $347.70 / $468.14
| Professional | | $276.57 | $347.70 | $468.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.24 / $312.24 / $391.87
| Professional | | $312.24 | $312.24 | $391.87 |