- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $128.82 / $204.17
| Facility | | $51.29 | $128.82 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $47.86 / $123.03
| Professional | | $28.18 | $47.86 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $72.44 / $162.18
| Facility | | $46.77 | $72.44 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $51.29 / $190.55
| Professional | | $25.70 | $51.29 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $125.89 / $181.97
| Facility | | $100.00 | $125.89 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $47.86 / $47.86
| Professional | | $38.90 | $47.86 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $87.10 / $199.53
| Facility | | $39.81 | $87.10 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $63.10 / $134.90
| Professional | | $30.90 | $63.10 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $3,630.78 / $9,772.37
| Facility | | $44.67 | $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 / $104.71
| Professional | | $51.29 | $51.29 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $72.44 / $162.18
| Facility | | $46.77 | $72.44 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $51.29 / $204.17
| Professional | | $25.70 | $51.29 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $51.29 / $83.18
| Facility | | $43.65 | $51.29 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $43.65 / $117.49
| Professional | | $25.70 | $43.65 | $117.49 |