- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $144.54 / $275.42
| Facility | | $61.66 | $144.54 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $60.26 / $288.40
| Professional | | $47.86 | $60.26 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $91.20 / $309.03
| Facility | | $58.88 | $91.20 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $64.57 / $138.04
| Professional | | $38.90 | $64.57 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $158.49 / $251.19
| Facility | | $125.89 | $158.49 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $83.18
| Professional | | $61.66 | $61.66 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $102.33 / $251.19
| Facility | | $50.12 | $102.33 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $79.43 / $109.65
| Professional | | $47.86 | $79.43 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $9,772.37
| Facility | | $56.23 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $109.65
| Professional | | $93.33 | $93.33 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $194.98
| Professional | | $64.57 | $64.57 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $91.20 / $309.03
| Facility | | $58.88 | $91.20 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $64.57 / $138.04
| Professional | | $38.90 | $64.57 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $64.57 / $107.15
| Facility | | $37.15 | $64.57 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $54.95 / $154.88
| Professional | | $32.36 | $54.95 | $154.88 |