- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.63 / $66.75 / $515.42
| Facility | | $48.63 | $66.75 | $515.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.81 / $38.26 / $300.58
| Professional | | $29.81 | $38.26 | $300.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.83 / $42.27 / $101.36
| Facility | | $25.83 | $42.27 | $101.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.03 / $31.48 / $73.54
| Professional | | $23.03 | $31.48 | $73.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.08 / $76.50 / $186.39
| Facility | | $37.08 | $76.50 | $186.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.87 / $42.92 / $112.32
| Professional | | $30.87 | $42.92 | $112.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.08 / $69.11 / $93.27
| Professional | | $43.08 | $69.11 | $93.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.26 / $264.26 / $1,233.38
| Facility | | $264.26 | $264.26 | $1,233.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.47 / $68.84 / $147.86
| Professional | | $29.47 | $68.84 | $147.86 |