- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $213.80 / $851.14
| Facility | | $74.13 | $213.80 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $75.86 / $199.53
| Professional | | $57.54 | $75.86 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $102.33 / $257.04
| Facility | | $66.07 | $102.33 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $75.86 / $245.47
| Professional | | $44.67 | $75.86 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $177.83 / $257.04
| Facility | | $141.25 | $177.83 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $72.44
| Professional | | $69.18 | $69.18 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $102.33 / $158.49
| Facility | | $57.54 | $102.33 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $72.44 / $194.98
| Professional | | $44.67 | $72.44 | $194.98 |
- 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
- $107.15 / $107.15 / $125.89
| Professional | | $107.15 | $107.15 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $158.49
| Professional | | $74.13 | $74.13 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $177.83 / $691.83
| Facility | | $85.11 | $177.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $102.33 / $257.04
| Facility | | $66.07 | $102.33 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $75.86 / $281.84
| Professional | | $44.67 | $75.86 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $74.13 / $120.23
| Facility | | $58.88 | $74.13 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $74.13 / $154.88
| Professional | | $44.67 | $74.13 | $154.88 |