- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.50 / $136.58 / $2,042.00
| Facility | | $59.50 | $136.58 | $2,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.50 / $114.39 / $192.35
| Professional | | $59.50 | $114.39 | $192.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $87.45 / $87.45 / $87.45
| Professional | 50 | $87.45 | $87.45 | $87.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $50.68 / $514.91
| Facility | | $0.98 | $50.68 | $514.91 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.02 / $1.50 / $1.50
| Facility | 50 | $0.02 | $1.50 | $1.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.21 / $220.40 / $459.71
| Professional | | $117.21 | $220.40 | $459.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $175.04 / $318.50 / $689.57
| Professional | 50 | $175.04 | $318.50 | $689.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.26 / $481.36 / $1,157.97
| Facility | | $339.26 | $481.36 | $1,157.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.79 / $256.61 / $550.52
| Professional | | $127.79 | $256.61 | $550.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.93 / $440.08 / $911.79
| Facility | | $275.93 | $440.08 | $911.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.77 / $240.24 / $466.16
| Professional | | $128.77 | $240.24 | $466.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.39 / $162.13 / $366.00
| Facility | | $74.39 | $162.13 | $366.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.19 / $255.48 / $631.00
| Professional | | $134.19 | $255.48 | $631.00 |
- 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
- $131.76 / $221.48 / $488.34
| Professional | | $131.76 | $221.48 | $488.34 |