- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.87 / $245.30 / $247.76
| Facility | | $241.87 | $245.30 | $247.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $255.11
| Professional | | $245.30 | $245.30 | $255.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.71 / $245.30 / $308.68
| Professional | | $242.71 | $245.30 | $308.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.73 / $223.73 / $234.92
| Facility | | $223.73 | $223.73 | $234.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.73 / $223.73 / $223.73
| Professional | | $223.73 | $223.73 | $223.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.42 / $238.69 / $274.62
| Facility | | $231.42 | $238.69 | $274.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $245.30
| Professional | | $245.30 | $245.30 | $245.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.30 / $300.85 / $520.70
| Facility | | $245.30 | $300.85 | $520.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.99 / $245.30 / $421.65
| Professional | | $242.99 | $245.30 | $421.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $254.56
| Facility | | $245.30 | $245.30 | $254.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $254.56 / $254.56
| Professional | | $245.30 | $254.56 | $254.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.42 / $245.30 / $597.00
| Facility | | $231.42 | $245.30 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $266.13
| Professional | | $245.30 | $245.30 | $266.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $245.30 / $376.39
| Professional | | $245.30 | $245.30 | $376.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.56 / $254.56 / $254.56
| Facility | | $254.56 | $254.56 | $254.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.30 / $254.56 / $254.56
| Professional | | $245.30 | $254.56 | $254.56 |