- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $77.62 / $144.54
| Facility | | $32.36 | $77.62 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $30.90 / $151.36
| Professional | | $25.12 | $30.90 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $47.86 / $162.18
| Facility | | $30.90 | $47.86 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $33.88 / $72.44
| Professional | | $16.98 | $33.88 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $83.18 / $131.83
| Facility | | $66.07 | $83.18 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $43.65
| Professional | | $31.62 | $31.62 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $53.70 / $131.83
| Facility | | $26.30 | $53.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $41.69 / $56.23
| Professional | | $24.55 | $41.69 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $3,630.78 / $9,772.37
| Facility | | $50.12 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $48.98 / $57.54
| Professional | | $48.98 | $48.98 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $102.33
| Professional | | $33.88 | $33.88 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $47.86 / $162.18
| Facility | | $30.90 | $47.86 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $33.88 / $72.44
| Professional | | $16.98 | $33.88 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $33.88 / $54.95
| Facility | | $19.50 | $33.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $28.18 / $85.11
| Professional | | $13.80 | $28.18 | $85.11 |