- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.71 / $24.71 / $24.71
| Facility | | $24.71 | $24.71 | $24.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.71 / $24.71 / $42.81
| Professional | | $24.71 | $24.71 | $42.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.04 / $161.11 / $268.66
| Facility | | $38.04 | $161.11 | $268.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.09 / $38.04 / $55.23
| Professional | | $22.09 | $38.04 | $55.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.61 / $38.61 / $114.67
| Facility | | $38.61 | $38.61 | $114.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.70 / $40.20 / $40.20
| Professional | | $35.70 | $40.20 | $40.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.89 / $33.97 / $44.53
| Facility | | $30.89 | $33.97 | $44.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.88 / $33.97 / $65.63
| Professional | | $28.88 | $33.97 | $65.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.13 / $46.13 / $48.44
| Professional | | $46.13 | $46.13 | $48.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.03 / $27.03 / $27.03
| Professional | | $27.03 | $27.03 | $27.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $268.66 / $268.66
| Facility | | $114.82 | $268.66 | $268.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.85 / $28.22 / $55.23
| Professional | | $19.85 | $28.22 | $55.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.32 / $28.53 / $55.23
| Professional | | $20.32 | $28.53 | $55.23 |