- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $389.05 / $549.54
| Facility | | $123.03 | $389.05 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $138.04 / $165.96
| Professional | | $114.82 | $138.04 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $446.68 / $831.76
| Facility | | $181.97 | $446.68 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $512.86
| Professional | | $104.71 | $173.78 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $218.78 / $316.23
| Facility | | $173.78 | $218.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $165.96
| Professional | | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $134.90 / $281.84
| Facility | | $117.49 | $134.90 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $257.04
| Professional | | $213.80 | $213.80 | $257.04 |
- 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
- $251.19 / $251.19 / $295.12
| Professional | | $251.19 | $251.19 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $371.54
| Professional | | $173.78 | $173.78 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $446.68 / $831.76
| Facility | | $181.97 | $446.68 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $512.86
| Professional | | $104.71 | $173.78 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $208.93
| Facility | | $104.71 | $173.78 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $363.08
| Professional | | $104.71 | $173.78 | $363.08 |