- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.17 / $53.39 / $1,569.46
| Facility | | $39.17 | $53.39 | $1,569.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.15 / $64.98 / $116.68
| Professional | | $39.15 | $64.98 | $116.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.42 / $192.38 / $291.60
| Facility | | $93.42 | $192.38 | $291.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.80 / $107.47 / $602.00
| Professional | | $45.80 | $107.47 | $602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.51 / $198.93 / $261.02
| Facility | | $56.51 | $198.93 | $261.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.98 / $80.50 / $156.76
| Professional | | $53.98 | $80.50 | $156.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.24 / $279.74 / $604.16
| Facility | | $136.24 | $279.74 | $604.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.96 / $100.78 / $191.66
| Professional | | $55.96 | $100.78 | $191.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.12 / $81.98 / $8,090.00
| Facility | | $46.12 | $81.98 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.88 / $64.95 / $109.24
| Professional | | $34.88 | $64.95 | $109.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.22 / $106.70 / $170.52
| Professional | | $52.22 | $106.70 | $170.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.36 / $63.06 / $98.06
| Professional | | $62.36 | $63.06 | $98.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.38 / $192.38 / $192.38
| Facility | | $192.38 | $192.38 | $192.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.16 / $160.72 / $693.25
| Professional | | $70.16 | $160.72 | $693.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.52 / $110.81 / $207.91
| Professional | | $64.52 | $110.81 | $207.91 |