- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Facility | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $181.97 / $269.15
| Professional | | $128.82 | $181.97 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Professional | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $630.96 / $776.25
| Professional | | $234.42 | $630.96 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $234.42 / $346.74
| Facility | | $186.21 | $234.42 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $251.19 / $338.84
| Professional | | $229.09 | $251.19 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $288.40 / $309.03
| Facility | | $245.47 | $288.40 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $309.03 / $309.03
| Professional | | $275.42 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $446.68
| Facility | | $154.88 | $263.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $269.15 / $323.59
| Professional | | $87.10 | $269.15 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $436.52 / $1,174.90
| Facility | | $257.04 | $436.52 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $346.74 / $346.74
| Professional | | $316.23 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $281.84 / $630.96
| Facility | | $144.54 | $281.84 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $144.54 / $275.42
| Professional | | $131.83 | $144.54 | $275.42 |