- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.15 / $156.46 / $425.68
| Facility | | $62.15 | $156.46 | $425.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.49 / $39.06 / $47.63
| Professional | | $36.49 | $39.06 | $47.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.45 / $82.88 / $260.00
| Facility | | $43.45 | $82.88 | $260.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.58 / $47.63 / $116.02
| Professional | | $28.58 | $47.63 | $116.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.85 / $133.52 / $233.43
| Facility | | $83.85 | $133.52 | $233.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.77 / $44.77 / $57.56
| Professional | | $44.77 | $44.77 | $57.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.29 / $69.33 / $159.50
| Facility | | $33.29 | $69.33 | $159.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.73 / $50.44 / $91.75
| Professional | | $28.73 | $50.44 | $91.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.80 / $3,472.00 / $9,239.00
| Facility | | $80.80 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.61 / $68.61 / $80.72
| Professional | | $68.61 | $68.61 | $80.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.63 / $66.02 / $172.22
| Professional | | $47.63 | $66.02 | $172.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.76 / $58.63 / $305.00
| Facility | | $54.76 | $58.63 | $305.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.88 / $260.00 / $260.00
| Facility | | $82.88 | $260.00 | $260.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.86 / $31.94 / $94.94
| Professional | | $22.86 | $31.94 | $94.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.10 / $54.17 / $113.88
| Facility | | $43.10 | $54.17 | $113.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.86 / $33.60 / $94.94
| Professional | | $22.86 | $33.60 | $94.94 |