- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $47.86 / $123.03
| Facility | | $30.20 | $47.86 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $64.57 / $151.36
| Professional | | $30.20 | $64.57 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $67.61 / $331.13
| Facility | | $60.26 | $67.61 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $53.70 / $102.33
| Professional | | $28.84 | $53.70 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $134.90
| Facility | | $44.67 | $44.67 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $58.88 / $79.43
| Professional | | $45.71 | $58.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.48 / $44.67 / $44.67
| Facility | | $35.48 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $54.95
| Professional | | $38.02 | $38.02 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $93.33
| Professional | | $60.26 | $60.26 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $37.15
| Professional | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $67.61 / $331.13
| Facility | | $60.26 | $67.61 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $57.54 / $107.15
| Professional | | $29.51 | $57.54 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $28.84 / $47.86
| Facility | | $0.05 | $28.84 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $39.81 / $66.07
| Professional | | $26.92 | $39.81 | $66.07 |