- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.77 / $84.93 / $196.32
| Facility | | $30.77 | $84.93 | $196.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.07 / $27.96 / $30.77
| Professional | | $27.07 | $27.96 | $30.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.47 / $56.20 / $275.00
| Facility | | $29.47 | $56.20 | $275.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.38 / $32.29 / $78.68
| Professional | | $19.38 | $32.29 | $78.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.09 / $90.92 / $158.94
| Facility | | $57.09 | $90.92 | $158.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.36 / $30.36 / $41.32
| Professional | | $30.36 | $30.36 | $41.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.57 / $47.99 / $110.36
| Facility | | $22.57 | $47.99 | $110.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.36 / $35.71 / $54.69
| Professional | | $19.36 | $35.71 | $54.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.68 / $46.68 / $54.91
| Professional | | $46.68 | $46.68 | $54.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.29 / $44.77 / $120.23
| Professional | | $32.29 | $44.77 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.52 / $42.09 / $106.89
| Facility | | $40.52 | $42.09 | $106.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.20 / $275.00 / $275.00
| Facility | | $56.20 | $275.00 | $275.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.50 / $21.66 / $68.18
| Professional | | $15.50 | $21.66 | $68.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.50 / $27.08 / $61.57
| Professional | | $15.50 | $27.08 | $61.57 |