- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.55 / $83.30 / $252.76
| Facility | | $46.55 | $83.30 | $252.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.50 / $39.31 / $146.08
| Professional | | $32.50 | $39.31 | $146.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.13 / $94.82 / $312.00
| Facility | | $42.13 | $94.82 | $312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.72 / $86.22 / $173.67
| Professional | | $15.72 | $86.22 | $173.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.42 / $88.84 / $110.85
| Facility | | $28.42 | $88.84 | $110.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.61 / $72.30 / $180.79
| Professional | | $50.61 | $72.30 | $180.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.87 / $67.95 / $131.58
| Facility | | $28.87 | $67.95 | $131.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.00 / $33.79 / $106.22
| Professional | | $21.00 | $33.79 | $106.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.31 / $43.24 / $53.07
| Professional | | $39.31 | $43.24 | $53.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.38 / $45.21 / $89.00
| Professional | | $35.38 | $45.21 | $89.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.40 / $186.72 / $186.72
| Facility | | $68.40 | $186.72 | $186.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.55 / $196.55 / $294.83
| Professional | | $196.55 | $196.55 | $294.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.72 / $51.61 / $119.12
| Facility | | $33.72 | $51.61 | $119.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.00 / $45.21 / $80.78
| Professional | | $26.00 | $45.21 | $80.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.97 / $137.97 / $137.97
| Professional | | $137.97 | $137.97 | $137.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.51 / $16.51 / $77.83
| Professional | | $16.51 | $16.51 | $77.83 |