- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $389.05 / $588.84
| Professional | | $323.59 | $389.05 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Professional | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $1,412.54 / $1,737.80
| Professional | | $512.86 | $1,412.54 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $741.31
| Facility | | $398.11 | $501.19 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $537.03 / $724.44
| Professional | | $501.19 | $537.03 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $645.65 / $676.08
| Facility | | $524.81 | $645.65 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $676.08 / $676.08
| Professional | | $660.69 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $575.44 / $891.25
| Facility | | $346.74 | $575.44 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $588.84 / $707.95
| Professional | | $87.10 | $588.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $954.99 / $2,570.40
| Facility | | $562.34 | $954.99 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $758.58 / $758.58
| Professional | | $676.08 | $758.58 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,071.52 / $1,412.54
| Facility | | $323.59 | $1,071.52 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $323.59 / $616.60
| Professional | | $295.12 | $323.59 | $616.60 |