- 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 / $83.30 / $200.95
| Professional | | $31.42 | $83.30 | $200.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.23 / $144.68 / $307.42
| Facility | | $55.23 | $144.68 | $307.42 |
- 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
- $46.78 / $89.49 / $89.49
| Professional | | $46.78 | $89.49 | $89.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.71 / $63.60 / $107.49
| Facility | | $30.71 | $63.60 | $107.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.26 / $50.02 / $191.42
| Professional | | $28.26 | $50.02 | $191.42 |
- 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 / $417.95 / $417.95
| Facility | | $82.22 | $417.95 | $417.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $28.35 / $236.25
| Professional | | $28.35 | $28.35 | $236.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $28.35 / $82.69
| Professional | | $28.35 | $28.35 | $82.69 |