- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $83.18 / $177.83
| Facility | | $10.00 | $83.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $46.77 / $60.26
| Professional | | $10.00 | $46.77 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $67.61 / $288.40
| Facility | | $44.67 | $67.61 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $53.70 / $125.89
| Professional | | $14.79 | $53.70 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $120.23 / $173.78
| Facility | | $97.72 | $120.23 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $57.54 / $60.26
| Professional | | $14.79 | $57.54 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $39.81 / $97.72
| Facility | | $12.59 | $39.81 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $69.18 / $93.33
| Professional | | $9.12 | $69.18 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $3,630.78 / $9,772.37
| Facility | | $16.60 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $102.33
| Professional | | $87.10 | $87.10 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $60.26 / $131.83
| Professional | | $44.67 | $60.26 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $67.61 / $288.40
| Facility | | $44.67 | $67.61 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $53.70 / $125.89
| Professional | | $14.79 | $53.70 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $36.31 / $60.26
| Facility | | $9.55 | $36.31 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $36.31 / $60.26
| Professional | | $9.55 | $36.31 | $60.26 |