- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $91.20 / $165.96
| Facility | | $25.12 | $91.20 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $32.36 / $120.23
| Professional | | $25.12 | $32.36 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $46.77 / $134.90
| Facility | | $30.20 | $46.77 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $46.77 / $398.11
| Professional | | $30.20 | $46.77 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $89.13 / $177.83
| Facility | | $64.57 | $89.13 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $38.02 / $39.81
| Professional | | $33.88 | $38.02 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $53.70 / $102.33
| Facility | | $26.30 | $53.70 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $43.65 / $97.72
| Professional | | $20.89 | $43.65 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $3,630.78 / $9,772.37
| Facility | | $47.86 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $69.18
| Professional | | $58.88 | $58.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $60.26 / $102.33
| Professional | | $34.67 | $60.26 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $46.77 / $134.90
| Facility | | $30.20 | $46.77 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $46.77 / $398.11
| Professional | | $34.67 | $46.77 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $40.74 / $44.67
| Facility | | $24.55 | $40.74 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $43.65 / $117.49
| Professional | | $24.55 | $43.65 | $117.49 |