- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $190.55 / $588.84
| Facility | | $66.07 | $190.55 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $67.61 / $194.98
| Professional | | $47.86 | $67.61 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $91.20 / $229.09
| Facility | | $60.26 | $91.20 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $66.07 / $218.78
| Professional | | $38.90 | $66.07 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $162.18 / $229.09
| Facility | | $128.82 | $162.18 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $83.18 / $83.18
| Professional | | $64.57 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $89.13 / $138.04
| Facility | | $51.29 | $89.13 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $66.07 / $169.82
| Professional | | $38.90 | $66.07 | $169.82 |
- 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
- $93.33 / $93.33 / $112.20
| Professional | | $93.33 | $93.33 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $66.07 / $138.04
| Professional | | $66.07 | $66.07 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $123.03 / $186.21
| Facility | | $81.28 | $123.03 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $91.20 / $229.09
| Facility | | $60.26 | $91.20 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $66.07 / $245.47
| Professional | | $38.90 | $66.07 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $66.07 / $107.15
| Facility | | $53.70 | $66.07 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $66.07 / $134.90
| Professional | | $38.90 | $66.07 | $134.90 |