- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.04 / $181.73 / $294.64
| Facility | | $119.04 | $181.73 | $294.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.33 / $187.35 / $749.41
| Professional | | $160.33 | $187.35 | $749.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.19 / $781.56 / $1,728.76
| Facility | | $260.19 | $781.56 | $1,728.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.37 / $260.19 / $406.17
| Professional | | $152.37 | $260.19 | $406.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.46 / $537.09 / $691.67
| Facility | | $441.46 | $537.09 | $691.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.66 / $281.26 / $281.26
| Professional | | $239.66 | $281.26 | $281.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.92 / $240.58 / $291.58
| Facility | | $194.92 | $240.58 | $291.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.29 / $194.92 / $320.76
| Professional | | $142.29 | $194.92 | $320.76 |
- 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
- $336.75 / $336.75 / $353.59
| Professional | | $336.75 | $336.75 | $353.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.80 / $114.80 / $118.15
| Facility | | $114.80 | $114.80 | $118.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.70 / $210.56 / $210.56
| Professional | | $120.70 | $210.56 | $210.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.24 / $1,728.76 / $1,728.76
| Facility | | $633.24 | $1,728.76 | $1,728.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.33 / $207.50 / $406.17
| Professional | | $138.33 | $207.50 | $406.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.65 / $207.50 / $336.75
| Professional | | $140.65 | $207.50 | $336.75 |