- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $389.05 / $389.05
| Facility | | $169.82 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $114.82 / $169.82
| Professional | | $100.00 | $114.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $380.19 / $389.05
| Facility | | $309.03 | $380.19 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.89 / $501.19
| Professional | | $5.01 | $5.89 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $457.09 / $724.44
| Facility | | $389.05 | $457.09 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $363.08 / $446.68
| Professional | | $162.18 | $363.08 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $602.56 / $912.01
| Facility | | $158.49 | $602.56 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $954.99
| Professional | | $851.14 | $851.14 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $169.82 / $501.19
| Facility | | $128.82 | $169.82 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $85.11 / $707.95
| Professional | | $64.57 | $85.11 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $338.84 / $467.74
| Professional | | $229.09 | $338.84 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $676.08 / $676.08
| Facility | | $288.40 | $676.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $707.95 / $707.95
| Professional | | $208.93 | $707.95 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $776.25 / $1,096.48
| Professional | | $416.87 | $776.25 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $169.82
| Facility | | $114.82 | $114.82 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $85.11 / $234.42
| Professional | | $60.26 | $85.11 | $234.42 |