- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.68 / $65.16 / $598.50
| Facility | | $25.68 | $65.16 | $598.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $194.17 / $194.17 / $194.17
| Facility | 50 | $194.17 | $194.17 | $194.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.68 / $48.96 / $95.38
| Professional | | $25.68 | $48.96 | $95.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $236.63 / $355.50 / $355.50
| Professional | 50 | $236.63 | $355.50 | $355.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.91 / $464.25 / $1,057.80
| Facility | | $203.91 | $464.25 | $1,057.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $359.31 / $545.15 / $955.87
| Facility | 50 | $359.31 | $545.15 | $955.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.24 / $99.35 / $218.48
| Professional | | $48.24 | $99.35 | $218.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.36 / $140.25 / $327.72
| Professional | 50 | $72.36 | $140.25 | $327.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.94 / $226.94 / $545.94
| Facility | | $159.94 | $226.94 | $545.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.37 / $118.73 / $255.92
| Professional | | $54.37 | $118.73 | $255.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.09 / $207.48 / $429.88
| Facility | | $130.09 | $207.48 | $429.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.84 / $106.45 / $219.10
| Professional | | $53.84 | $106.45 | $219.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $68.26 / $176.35
| Facility | | $34.67 | $68.26 | $176.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.95 / $126.58 / $255.66
| Professional | | $64.95 | $126.58 | $255.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $236.61 / $236.61 / $394.03
| Professional | 50 | $236.61 | $236.61 | $394.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.78 / $110.43 / $238.81
| Professional | | $62.78 | $110.43 | $238.81 |