- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.06 / $99.22 / $183.26
| Facility | | $41.06 | $99.22 | $183.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $62.30 / $104.13
| Professional | | $39.81 | $62.30 | $104.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.29 / $99.68 / $170.54
| Facility | | $38.29 | $99.68 | $170.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $49.05 / $60.36
| Professional | | $39.81 | $49.05 | $60.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.72 / $50.80 / $108.28
| Facility | | $42.72 | $50.80 | $108.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.60 / $54.60 / $54.60
| Facility | | $54.60 | $54.60 | $54.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.60 / $54.60 / $54.60
| Professional | | $54.60 | $54.60 | $54.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.37 / $79.62 / $8,090.00
| Facility | | $47.37 | $79.62 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.84 / $39.81 / $84.40
| Professional | | $33.84 | $39.81 | $84.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.98 / $171.55 / $286.94
| Facility | | $43.98 | $171.55 | $286.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.96 / $52.96 / $170.54
| Facility | | $52.96 | $52.96 | $170.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.05 / $57.62 / $73.58
| Professional | | $49.05 | $57.62 | $73.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.81 / $37.19 / $57.78
| Facility | | $33.81 | $37.19 | $57.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.05 / $57.62 / $70.93
| Professional | | $49.05 | $57.62 | $70.93 |