- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.00 / $86.78 / $117.55
| Facility | | $27.00 | $86.78 | $117.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.36 / $27.00 / $38.57
| Professional | | $25.36 | $27.00 | $38.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.50 / $67.11 / $183.21
| Facility | | $28.50 | $67.11 | $183.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.51 / $38.57 / $93.95
| Professional | | $18.51 | $38.57 | $93.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.25 / $85.97 / $155.75
| Facility | | $7.25 | $85.97 | $155.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.26 / $36.26 / $38.18
| Professional | | $36.26 | $36.26 | $38.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.82 / $26.95 / $87.75
| Facility | | $24.82 | $26.95 | $87.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.60 / $44.19 / $58.85
| Professional | | $21.60 | $44.19 | $58.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.54 / $55.54 / $65.34
| Professional | | $55.54 | $55.54 | $65.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.57 / $46.48 / $92.18
| Professional | | $38.57 | $46.48 | $92.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.81 / $206.67 / $257.25
| Facility | | $63.81 | $206.67 | $257.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.11 / $183.21 / $183.21
| Facility | | $67.11 | $183.21 | $183.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.60 / $23.14 / $67.50
| Professional | | $12.60 | $23.14 | $67.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.71 / $38.57 / $46.28
| Facility | | $34.71 | $38.57 | $46.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.60 / $23.14 / $57.86
| Professional | | $12.60 | $23.14 | $57.86 |