- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.66 / $119.66 / $119.66
| Facility | | $119.66 | $119.66 | $119.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.99 / $119.66 / $179.34
| Professional | | $101.99 | $119.66 | $179.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.87 / $132.87 / $162.87
| Professional | | $132.87 | $132.87 | $162.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.74 / $305.74 / $305.74
| Facility | | $305.74 | $305.74 | $305.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.88 / $448.59 / $509.76
| Facility | | $383.88 | $448.59 | $509.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.29 / $207.19 / $270.39
| Professional | | $58.29 | $207.19 | $270.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.73 / $119.66 / $142.87
| Facility | | $117.73 | $119.66 | $142.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.73 / $142.87 / $220.26
| Facility | | $117.73 | $142.87 | $220.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.49 / $71.27 / $133.12
| Professional | | $50.49 | $71.27 | $133.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $58.40 / $70.00
| Professional | | $50.00 | $58.40 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.73 / $119.66 / $142.87
| Facility | | $117.73 | $119.66 | $142.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.75 / $214.31 / $365.18
| Professional | | $138.75 | $214.31 | $365.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.02 / $290.02 / $668.63
| Facility | | $290.02 | $290.02 | $668.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.29 / $627.84 / $711.49
| Professional | | $58.29 | $627.84 | $711.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.87 / $142.87 / $142.87
| Professional | | $142.87 | $142.87 | $142.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.87 / $142.87 / $142.87
| Professional | | $142.87 | $142.87 | $142.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.44 / $68.30 / $113.79
| Professional | | $47.44 | $68.30 | $113.79 |