- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.24 / $146.96 / $277.18
| Facility | | $53.24 | $146.96 | $277.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.40 / $53.24 / $80.04
| Professional | | $50.40 | $53.24 | $80.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.97 / $97.25 / $265.48
| Facility | | $50.97 | $97.25 | $265.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.40 / $55.89 / $136.13
| Professional | | $29.40 | $55.89 | $136.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.25 / $156.46 / $273.52
| Facility | | $98.25 | $156.46 | $273.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.54 / $52.54 / $71.48
| Professional | | $52.54 | $52.54 | $71.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.04 / $81.83 / $188.22
| Facility | | $39.04 | $81.83 | $188.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.90 / $61.79 / $85.19
| Professional | | $32.90 | $61.79 | $85.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.33 / $3,472.00 / $9,239.00
| Facility | | $80.33 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.73 / $80.73 / $94.99
| Professional | | $80.73 | $80.73 | $94.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.89 / $77.45 / $208.00
| Professional | | $55.89 | $77.45 | $208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.55 / $123.55 / $123.55
| Facility | | $123.55 | $123.55 | $123.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.25 / $265.48 / $265.48
| Facility | | $97.25 | $265.48 | $265.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.83 / $33.53 / $117.96
| Professional | | $26.83 | $33.53 | $117.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.83 / $33.53 / $100.05
| Professional | | $26.83 | $33.53 | $100.05 |