- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $114.82 / $208.93
| Facility | | $58.88 | $114.82 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $48.98 / $177.83
| Professional | | $38.90 | $48.98 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $67.61 / $204.17
| Facility | | $43.65 | $67.61 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $60.26 / $363.08
| Professional | | $35.48 | $60.26 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $117.49 / $169.82
| Facility | | $93.33 | $117.49 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Professional | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $81.28 / $165.96
| Facility | | $40.74 | $81.28 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $57.54 / $151.36
| Professional | | $31.62 | $57.54 | $151.36 |
- 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
- $85.11 / $85.11 / $100.00
| Professional | | $85.11 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $123.03
| Professional | | $58.88 | $58.88 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $67.61 / $204.17
| Facility | | $43.65 | $67.61 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $61.66 / $363.08
| Professional | | $35.48 | $61.66 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $58.88 / $70.79
| Facility | | $36.31 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $58.88 / $112.20
| Professional | | $35.48 | $58.88 | $112.20 |