- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $147.91 / $371.54
| Facility | | $51.29 | $147.91 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $43.65 / $89.13
| Professional | | $38.90 | $43.65 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $72.44 / $245.47
| Facility | | $46.77 | $72.44 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $51.29 / $109.65
| Professional | | $25.12 | $51.29 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $125.89 / $199.53
| Facility | | $100.00 | $125.89 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $47.86 / $67.61
| Professional | | $47.86 | $47.86 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $60.26 / $87.10
| Facility | | $36.31 | $60.26 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $61.66 / $91.20
| Professional | | $34.67 | $61.66 | $91.20 |
- 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
- $74.13 / $74.13 / $87.10
| Professional | | $74.13 | $74.13 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $51.29 / $154.88
| Professional | | $51.29 | $51.29 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $61.66 / $147.91
| Facility | | $47.86 | $61.66 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $72.44 / $245.47
| Facility | | $46.77 | $72.44 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $51.29 / $109.65
| Professional | | $25.70 | $51.29 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $51.29 / $87.10
| Facility | | $30.90 | $51.29 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $43.65 / $128.82
| Professional | | $20.42 | $43.65 | $128.82 |