- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $239.88 / $407.38
| Facility | | $81.28 | $239.88 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $104.71 / $398.11
| Professional | | $79.43 | $104.71 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $181.97 / $891.25
| Facility | | $177.83 | $181.97 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $141.25 / $190.55
| Professional | | $77.62 | $141.25 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $245.47 / $323.59
| Facility | | $208.93 | $245.47 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $125.89 / $125.89
| Professional | | $109.65 | $125.89 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $107.15 / $138.04
| Facility | | $107.15 | $107.15 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $123.03
| Professional | | $77.62 | $77.62 | $123.03 |
- 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
- $162.18 / $162.18 / $245.47
| Professional | | $162.18 | $162.18 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $107.15 / $107.15
| Professional | | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $181.97 / $891.25
| Facility | | $177.83 | $181.97 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $144.54 / $208.93
| Professional | | $77.62 | $144.54 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.14 / $95.50 / $234.42
| Facility | | $0.14 | $95.50 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $107.15 / $162.18
| Professional | | $72.44 | $107.15 | $162.18 |