- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.34 / $131.71 / $243.07
| Facility | | $33.34 | $131.71 | $243.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.72 / $33.34 / $57.10
| Professional | | $27.72 | $33.34 | $57.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.23 / $102.26 / $102.26
| Facility | | $84.23 | $102.26 | $102.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.81 / $33.65 / $64.44
| Professional | | $28.81 | $33.65 | $64.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.67 / $57.81 / $109.42
| Facility | | $31.67 | $57.81 | $109.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.27 / $37.36 / $61.64
| Professional | | $19.27 | $37.36 | $61.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.34 / $45.00 / $81.44
| Facility | | $33.34 | $45.00 | $81.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.11 / $35.11 / $37.85
| Professional | | $35.11 | $35.11 | $37.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.37 / $25.01 / $51.39
| Professional | | $17.37 | $25.01 | $51.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.52 / $197.98 / $197.98
| Facility | | $72.52 | $197.98 | $197.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.62 / $325.62 / $325.62
| Professional | | $325.62 | $325.62 | $325.62 |