- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $77.62 / $125.89
| Facility | | $28.18 | $77.62 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $26.92 / $131.83
| Professional | | $21.88 | $26.92 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $41.69 / $141.25
| Facility | | $26.92 | $41.69 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $29.51 / $63.10
| Professional | | $12.59 | $29.51 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $72.44 / $117.49
| Facility | | $58.88 | $72.44 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $38.02
| Professional | | $28.18 | $28.18 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $46.77 / $114.82
| Facility | | $22.91 | $46.77 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $36.31 / $50.12
| Professional | | $21.88 | $36.31 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $3,630.78 / $9,772.37
| Facility | | $42.66 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $42.66 / $50.12
| Professional | | $42.66 | $42.66 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $29.51 / $89.13
| Professional | | $29.51 | $29.51 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $41.69 / $141.25
| Facility | | $26.92 | $41.69 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $29.51 / $63.10
| Professional | | $14.13 | $29.51 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $29.51 / $48.98
| Facility | | $16.98 | $29.51 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $25.12 / $70.79
| Professional | | $5.25 | $25.12 | $70.79 |