- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.00 / $86.78 / $120.42
| Facility | | $27.00 | $86.78 | $120.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $27.00 / $31.24
| Professional | | $13.38 | $27.00 | $31.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.50 / $44.11 / $183.21
| Facility | | $28.50 | $44.11 | $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
- $54.00 / $89.09 / $155.75
| Facility | | $54.00 | $89.09 | $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
- $78.75 / $78.75 / $78.75
| Facility | | $78.75 | $78.75 | $78.75 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $13.50 / $23.14 / $57.86
| Professional | | $13.50 | $23.14 | $57.86 |