- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.89 / $301.89 / $326.04
| Facility | | $301.89 | $301.89 | $326.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.75 / $326.04 / $603.78
| Professional | | $289.75 | $326.04 | $603.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.57 / $410.57 / $410.57
| Professional | | $410.57 | $410.57 | $410.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.53 / $689.53 / $689.53
| Facility | | $689.53 | $689.53 | $689.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.82 / $499.82 / $499.82
| Facility | | $499.82 | $499.82 | $499.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.87 / $364.87 / $499.82
| Professional | | $364.87 | $364.87 | $499.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.07 / $3,076.44 / $3,076.44
| Facility | | $1,298.07 | $3,076.44 | $3,076.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,592.02 / $3,592.02 / $4,487.55
| Professional | | $3,592.02 | $3,592.02 | $4,487.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.64 / $480.54 / $689.53
| Facility | | $186.64 | $480.54 | $689.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.75 / $620.58 / $725.66
| Professional | | $188.75 | $620.58 | $725.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.64 / $480.54 / $689.53
| Facility | | $186.64 | $480.54 | $689.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.87 / $364.87 / $514.80
| Professional | | $364.87 | $364.87 | $514.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.30 / $382.03 / $445.50
| Facility | | $218.30 | $382.03 | $445.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.92 / $356.40 / $435.59
| Professional | | $240.92 | $356.40 | $435.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.66 / $352.40 / $689.53
| Professional | | $350.66 | $352.40 | $689.53 |