- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.21 / $150.21 / $151.37
| Facility | | $150.21 | $150.21 | $151.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.21 / $167.09 / $220.16
| Professional | | $150.21 | $167.09 | $220.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.58 / $979.30 / $1,640.11
| Facility | | $307.58 | $979.30 | $1,640.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.53 / $255.37 / $335.72
| Professional | | $142.53 | $255.37 | $335.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.36 / $443.92 / $571.67
| Facility | | $375.36 | $443.92 | $571.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.12 / $225.12 / $265.02
| Professional | | $225.12 | $225.12 | $265.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.98 / $212.98 / $212.98
| Facility | | $212.98 | $212.98 | $212.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $212.98 / $408.38
| Professional | | $155.47 | $212.98 | $408.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.33 / $278.33 / $292.26
| Professional | | $278.33 | $278.33 | $292.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.48 / $444.48 / $564.41
| Facility | | $444.48 | $444.48 | $564.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.75 / $261.75 / $261.75
| Professional | | $261.75 | $261.75 | $261.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.05 / $1,640.11 / $1,640.11
| Facility | | $715.05 | $1,640.11 | $1,640.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.81 / $171.50 / $335.72
| Professional | | $130.81 | $171.50 | $335.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.03 / $176.64 / $335.72
| Professional | | $133.03 | $176.64 | $335.72 |