- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.18 / $128.53 / $409.86
| Facility | | $36.18 | $128.53 | $409.86 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $405.09 / $972.84 / $972.84
| Facility | 50 | $405.09 | $972.84 | $972.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.75 / $55.29 / $144.40
| Professional | | $27.75 | $55.29 | $144.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.06 / $76.72 / $156.46
| Professional | | $43.06 | $76.72 | $156.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.85 / $253.25 / $371.02
| Facility | | $132.85 | $253.25 | $371.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.79 / $58.73 / $128.91
| Professional | | $22.79 | $58.73 | $128.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $180.94 / $180.94
| Facility | | $40.00 | $180.94 | $180.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $400.00 / $400.00
| Facility | | $400.00 | $400.00 | $400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.10 / $65.20 / $143.47
| Professional | | $26.10 | $65.20 | $143.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.82 / $424.20 / $1,226.00
| Facility | | $185.82 | $424.20 | $1,226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.98 / $96.25 / $171.31
| Professional | | $65.98 | $96.25 | $171.31 |