- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.76 / $109.20 / $174.33
| Facility | | $33.76 | $109.20 | $174.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.16 / $34.18 / $142.00
| Professional | | $27.16 | $34.18 | $142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.01 / $235.88 / $8,459.92
| Facility | | $177.01 | $235.88 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.51 / $32.51 / $32.51
| Professional | | $32.51 | $32.51 | $32.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.54 / $61.43 / $138.00
| Facility | | $39.54 | $61.43 | $138.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.83 / $39.97 / $85.35
| Professional | | $20.83 | $39.97 | $85.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.80 / $56.27 / $79.19
| Professional | | $24.80 | $56.27 | $79.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.46 / $127.46 / $137.59
| Facility | | $113.46 | $127.46 | $137.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.42 / $113.34 / $174.33
| Facility | | $35.42 | $113.34 | $174.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.84 / $50.64 / $172.14
| Professional | | $30.84 | $50.64 | $172.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.50 / $49.40 / $58.30
| Professional | | $39.50 | $49.40 | $58.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.70 / $69.34 / $138.00
| Facility | | $39.70 | $69.34 | $138.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.05 / $41.84 / $85.35
| Professional | | $22.05 | $41.84 | $85.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.68 / $41.68 / $41.68
| Facility | | $41.68 | $41.68 | $41.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.68 / $41.68 / $42.51
| Professional | | $41.68 | $41.68 | $42.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.51 / $25.01 / $61.50
| Professional | | $17.51 | $25.01 | $61.50 |