- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $338.84 / $707.95
| Facility | | $85.11 | $338.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $169.82 / $616.60
| Professional | | $125.89 | $169.82 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $281.84 / $1,380.38
| Facility | | $275.42 | $281.84 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $218.78 / $295.12
| Professional | | $120.23 | $218.78 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $501.19
| Facility | | $323.59 | $380.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $223.87 / $223.87
| Professional | | $208.93 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $173.78
| Facility | | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $181.97
| Professional | | $128.82 | $128.82 | $181.97 |
- 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
- $251.19 / $251.19 / $389.05
| Professional | | $251.19 | $251.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $371.54 / $371.54
| Facility | | $354.81 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $218.78
| Professional | | $173.78 | $173.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $281.84 / $1,380.38
| Facility | | $275.42 | $281.84 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $223.87 / $323.59
| Professional | | $120.23 | $223.87 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.21 / $169.82 / $363.08
| Facility | | $0.21 | $169.82 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $169.82 / $251.19
| Professional | | $112.20 | $169.82 | $251.19 |