- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $52.48 / $5,248.07
| Facility | | $38.90 | $52.48 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $64.57 / $213.80
| Professional | | $38.90 | $64.57 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $660.69
| Facility | | $93.33 | $147.91 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $87.10 / $194.98
| Professional | | $42.66 | $87.10 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $134.90 / $251.19
| Facility | | $44.67 | $134.90 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $79.43 / $165.96
| Professional | | $44.67 | $79.43 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $239.88 / $645.65
| Facility | | $134.90 | $239.88 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $95.50 / $186.21
| Professional | | $51.29 | $95.50 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $74.13 / $8,511.38
| Facility | | $42.66 | $74.13 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $72.44 / $128.82
| Professional | | $37.15 | $72.44 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $77.62 / $154.88
| Professional | | $42.66 | $77.62 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $97.72
| Professional | | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $660.69
| Facility | | $93.33 | $147.91 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $87.10 / $194.98
| Professional | | $42.66 | $87.10 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $208.93 / $354.81
| Facility | | $87.10 | $208.93 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $93.33 / $162.18
| Professional | | $48.98 | $93.33 | $162.18 |