- 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
- $151.36 / $245.47 / $1,023.29
| Professional | | $151.36 | $245.47 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $426.58 / $1,737.80
| Facility | | $398.11 | $426.58 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $323.59 / $426.58
| Professional | | $154.88 | $323.59 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $1,819.70
| Facility | | $602.56 | $602.56 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $489.78
| Professional | | $181.97 | $288.40 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $288.40
| Facility | | $213.80 | $213.80 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $288.40
| Professional | | $154.88 | $154.88 | $288.40 |
- 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
- $363.08 / $363.08 / $549.54
| Professional | | $363.08 | $363.08 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $263.03 / $263.03
| Professional | | $245.47 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $426.58 / $1,737.80
| Facility | | $398.11 | $426.58 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $323.59 / $426.58
| Professional | | $154.88 | $323.59 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $436.52 / $724.44
| Professional | | $269.15 | $436.52 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.25 / $173.78 / $426.58
| Facility | | $0.25 | $173.78 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $263.03 / $363.08
| Professional | | $147.91 | $263.03 | $363.08 |