- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $316.23 / $524.81
| Facility | | $123.03 | $316.23 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $158.49 / $446.68
| Professional | | $123.03 | $158.49 | $446.68 |
- 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
- $190.55 / $223.87 / $223.87
| Professional | | $190.55 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $177.83
| Facility | | $177.83 | $177.83 | $177.83 |
- 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
- $371.54 / $371.54 / $371.54
| Facility | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Professional | | $218.78 | $218.78 | $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 / $154.88 / $363.08
| Facility | | $0.21 | $154.88 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $169.82 / $251.19
| Professional | | $112.20 | $169.82 | $251.19 |