- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.79 / $36.29 / $139.24
| Facility | | $25.79 | $36.29 | $139.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.52 / $35.54 / $51.84
| Professional | | $23.52 | $35.54 | $51.84 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $85.57 / $85.57 / $85.57
| Professional | 25 | $85.57 | $85.57 | $85.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.52 / $50.00 / $51.77
| Professional | | $43.52 | $50.00 | $51.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $41.38 / $67.09
| Professional | | $27.00 | $41.38 | $67.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.44 / $40.59 / $54.80
| Facility | | $30.44 | $40.59 | $54.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.24 / $58.13 / $75.95
| Professional | | $42.24 | $58.13 | $75.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.70 / $57.70 / $57.70
| Facility | | $57.70 | $57.70 | $57.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.04 / $51.59 / $86.50
| Professional | | $32.04 | $51.59 | $86.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.70 / $57.70 / $57.70
| Facility | | $57.70 | $57.70 | $57.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.07 / $52.05 / $80.31
| Professional | | $34.07 | $52.05 | $80.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.38 / $67.99 / $101.43
| Professional | | $51.38 | $67.99 | $101.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.41 / $52.01 / $68.70
| Professional | | $49.41 | $52.01 | $68.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.26 / $55.33 / $88.61
| Professional | | $37.26 | $55.33 | $88.61 |