- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $338.84 / $616.60
| Facility | | $44.67 | $338.84 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $165.96 / $549.54 / $3,235.94
| Facility | 25 | $165.96 | $549.54 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $52.48 / $281.84
| Professional | | $32.36 | $52.48 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $45.71 / $104.71
| Professional | | $39.81 | $45.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $549.54 / $676.08
| Facility | | $213.80 | $549.54 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $53.70 / $60.26
| Professional | | $42.66 | $53.70 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $51.29 / $51.29
| Facility | | $39.81 | $51.29 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $323.59 / $416.87
| Facility | | $302.00 | $323.59 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $44.67 / $87.10
| Professional | | $33.88 | $44.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $41.69 / $63.10
| Professional | | $31.62 | $41.69 | $63.10 |