- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.61 / $95.36 / $195.27
| Facility | | $30.61 | $95.36 | $195.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.15 / $30.61 / $64.19
| Professional | | $23.15 | $30.61 | $64.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.30 / $45.25 / $113.80
| Facility | | $29.30 | $45.25 | $113.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.59 / $45.68 / $397.33
| Professional | | $29.59 | $45.68 | $397.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.01 / $95.33 / $210.66
| Facility | | $63.01 | $95.33 | $210.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.72 / $32.72 / $41.11
| Professional | | $32.72 | $32.72 | $41.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.49 / $55.75 / $124.06
| Facility | | $30.49 | $55.75 | $124.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.94 / $36.88 / $91.12
| Professional | | $20.94 | $36.88 | $91.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.72 / $3,472.00 / $9,239.00
| Facility | | $57.72 | $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
- $34.81 / $68.70 / $110.91
| Professional | | $34.81 | $68.70 | $110.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.57 / $514.48 / $514.48
| Facility | | $60.57 | $514.48 | $514.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.93 / $46.91 / $397.33
| Professional | | $26.93 | $46.91 | $397.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.93 / $44.89 / $134.35
| Professional | | $26.93 | $44.89 | $134.35 |