- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $19.05
| Professional | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $17.38 / $38.90
| Professional | | $10.72 | $17.38 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $47.86 / $69.18
| Facility | | $38.02 | $47.86 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.56 / $0.56 / $1.51
| Facility | | $0.56 | $0.56 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $34.67 / $43.65
| Professional | | $14.79 | $34.67 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $34.67 / $40.74
| Professional | | $34.67 | $34.67 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $47.86
| Professional | | $20.42 | $20.42 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $50.12 / $147.91
| Facility | | $26.92 | $50.12 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $17.38 / $38.90
| Professional | | $11.48 | $17.38 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $24.55 / $40.74
| Facility | | $12.02 | $24.55 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $20.42 / $43.65
| Professional | | $11.48 | $20.42 | $43.65 |