- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $93.33 / $194.98
| Facility | | $32.36 | $93.33 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $36.31 / $52.48
| Professional | | $30.90 | $36.31 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $42.66 / $169.82
| Facility | | $42.66 | $42.66 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $37.15
| Professional | | $21.38 | $21.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $131.83 / $199.53
| Professional | | $37.15 | $131.83 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $109.65 / $194.98
| Facility | | $67.61 | $109.65 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $31.62 / $85.11
| Professional | | $21.88 | $31.62 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $51.29 / $60.26
| Professional | | $42.66 | $51.29 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $83.18 / $83.18
| Professional | | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $69.18 / $112.20
| Facility | | $36.31 | $69.18 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $34.67 / $89.13
| Professional | | $34.67 | $34.67 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $51.29 / $10,000.00
| Facility | | $37.15 | $51.29 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $51.29 / $10,000.00
| Professional | | $37.15 | $51.29 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $42.66 / $51.29
| Facility | | $36.31 | $42.66 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $23.44 / $56.23
| Professional | | $16.60 | $23.44 | $56.23 |