- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $223.87 / $371.54
| Facility | | $81.28 | $223.87 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $81.28 / $549.54
| Professional | | $64.57 | $81.28 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $123.03 / $416.87
| Facility | | $79.43 | $123.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $87.10 / $181.97
| Professional | | $45.71 | $87.10 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $213.80 / $338.84
| Facility | | $169.82 | $213.80 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $112.20
| Professional | | $81.28 | $81.28 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $134.90 / $331.13
| Facility | | $67.61 | $134.90 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $107.15 / $169.82
| Professional | | $60.26 | $107.15 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $9,772.37
| Facility | | $56.23 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $125.89 / $147.91
| Professional | | $125.89 | $125.89 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $263.03
| Professional | | $87.10 | $87.10 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $123.03 / $416.87
| Facility | | $79.43 | $123.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $87.10 / $181.97
| Professional | | $45.71 | $87.10 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $87.10 / $141.25
| Facility | | $50.12 | $87.10 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $72.44 / $208.93
| Professional | | $42.66 | $72.44 | $208.93 |