- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.58 / $119.57 / $216.83
| Facility | | $41.58 | $119.57 | $216.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $41.58 / $66.48
| Professional | | $35.36 | $41.58 | $66.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.82 / $61.50 / $146.22
| Facility | | $39.82 | $61.50 | $146.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.19 / $45.83 / $173.10
| Professional | | $26.19 | $45.83 | $173.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.92 / $122.87 / $214.80
| Facility | | $85.92 | $122.87 | $214.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.84 / $55.84 / $55.84
| Professional | | $55.84 | $55.84 | $55.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.04 / $59.58 / $99.30
| Facility | | $34.04 | $59.58 | $99.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.23 / $43.77 / $113.67
| Professional | | $26.23 | $43.77 | $113.67 |
- 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
- $63.01 / $63.01 / $74.13
| Professional | | $63.01 | $63.01 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $141.94
| Professional | | $43.65 | $43.65 | $141.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.92 / $241.92 / $241.92
| Facility | | $241.92 | $241.92 | $241.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.95 / $207.34 / $207.34
| Facility | | $75.95 | $207.34 | $207.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.19 / $35.72 / $218.25
| Professional | | $26.19 | $35.72 | $218.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.19 / $33.71 / $89.33
| Professional | | $26.19 | $33.71 | $89.33 |