- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.18 / $148.57 / $300.02
| Facility | | $30.18 | $148.57 | $300.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.07 / $41.33 / $52.63
| Professional | | $28.07 | $41.33 | $52.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.45 / $73.20 / $93.11
| Facility | | $59.45 | $73.20 | $93.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.32 / $35.72 / $91.12
| Professional | | $26.32 | $35.72 | $91.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.66 / $48.65 / $92.52
| Facility | | $26.66 | $48.65 | $92.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.35 / $32.40 / $61.64
| Professional | | $16.35 | $32.40 | $61.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.07 / $45.00 / $81.44
| Facility | | $28.07 | $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
- Facility
- Modifier
- Low / Median / High Price
- $1,146.46 / $1,146.46 / $5,271.07
| Facility | | $1,146.46 | $1,146.46 | $5,271.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.81 / $22.81 / $37.02
| Professional | | $22.81 | $22.81 | $37.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.11 / $42.11 / $42.11
| Facility | | $42.11 | $42.11 | $42.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.13 / $21.05 / $49.04
| Professional | | $17.13 | $21.05 | $49.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.45 / $167.46 / $227.00
| Facility | | $73.45 | $167.46 | $227.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.62 / $325.62 / $325.62
| Professional | | $325.62 | $325.62 | $325.62 |