- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.61 / $100.94 / $201.22
| Facility | | $57.61 | $100.94 | $201.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.82 / $35.82 / $60.04
| Professional | | $24.82 | $35.82 | $60.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.01 / $49.44 / $107.45
| Facility | | $32.01 | $49.44 | $107.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $36.39 / $139.15
| Professional | | $21.05 | $36.39 | $139.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.04 / $92.52 / $171.85
| Facility | | $42.04 | $92.52 | $171.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.97 / $32.97 / $33.32
| Professional | | $32.97 | $32.97 | $33.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.37 / $47.90 / $79.84
| Facility | | $27.37 | $47.90 | $79.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.15 / $36.88 / $91.12
| Professional | | $21.15 | $36.88 | $91.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.42 / $50.42 / $59.31
| Professional | | $50.42 | $50.42 | $59.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.09 / $35.09 / $108.67
| Professional | | $35.09 | $35.09 | $108.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.32 / $52.69 / $159.25
| Facility | | $41.32 | $52.69 | $159.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.58 / $78.00 / $83.46
| Professional | | $35.58 | $78.00 | $83.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.26 / $166.68 / $166.68
| Facility | | $61.26 | $166.68 | $166.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $21.27 / $175.45
| Professional | | $21.05 | $21.27 | $175.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.12 / $38.57 / $80.00
| Facility | | $29.12 | $38.57 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.75 / $34.03 / $52.64
| Professional | | $31.75 | $34.03 | $52.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.05 / $35.09 / $72.52
| Professional | | $21.05 | $35.09 | $72.52 |