- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.59 / $160.60 / $450.05
| Facility | | $56.59 | $160.60 | $450.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.33 / $60.50 / $77.91
| Professional | | $51.33 | $60.50 | $77.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.13 / $209.16 / $407.65
| Facility | | $65.13 | $209.16 | $407.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.58 / $111.63 / $133.75
| Professional | | $48.58 | $111.63 | $133.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.66 / $435.39 / $435.39
| Facility | | $146.66 | $435.39 | $435.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.30 / $458.30 / $687.45
| Professional | | $458.30 | $458.30 | $687.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $91.66 / $137.49
| Facility | | $55.00 | $91.66 | $137.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.08 / $91.66 / $137.49
| Professional | | $87.08 | $91.66 | $137.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $114.58 / $320.81
| Professional | | $70.00 | $114.58 | $320.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.26 / $100.83 / $333.01
| Facility | | $62.26 | $100.83 | $333.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.58 / $114.58 / $171.40
| Professional | | $59.58 | $114.58 | $171.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.50 / $47.53 / $67.90
| Professional | | $38.50 | $47.53 | $67.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.27 / $45.27 / $91.66
| Professional | | $45.27 | $45.27 | $91.66 |