- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.00 / $108.68 / $144.00
| Facility | | $82.00 | $108.68 | $144.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.42 / $95.00 / $150.52
| Professional | | $31.42 | $95.00 | $150.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.23 / $144.68 / $276.58
| Facility | | $55.23 | $144.68 | $276.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $47.25 / $187.38
| Professional | | $28.35 | $47.25 | $187.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.04 / $107.31 / $187.60
| Facility | | $75.04 | $107.31 | $187.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.19 / $71.19 / $71.19
| Professional | | $71.19 | $71.19 | $71.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.71 / $57.73 / $107.49
| Facility | | $30.71 | $57.73 | $107.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.26 / $50.02 / $123.59
| Professional | | $28.26 | $50.02 | $123.59 |
- 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
- $68.15 / $68.15 / $80.18
| Professional | | $68.15 | $68.15 | $80.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.25 / $47.25 / $153.65
| Professional | | $47.25 | $47.25 | $153.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.22 / $276.58 / $276.58
| Facility | | $82.22 | $276.58 | $276.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $28.35 / $236.25
| Professional | | $28.35 | $28.35 | $236.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.53 / $47.25 / $56.70
| Facility | | $42.53 | $47.25 | $56.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $28.35 / $97.66
| Professional | | $28.35 | $28.35 | $97.66 |