- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.81 / $38.81 / $38.81
| Facility | | $38.81 | $38.81 | $38.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.61 / $38.81 / $74.42
| Professional | | $27.61 | $38.81 | $74.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.50 / $263.38 / $422.04
| Facility | | $79.50 | $263.38 | $422.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.89 / $68.29 / $90.24
| Professional | | $39.89 | $68.29 | $90.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.00 / $114.72 / $147.74
| Facility | | $97.00 | $114.72 | $147.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.13 / $58.13 / $58.17
| Professional | | $58.13 | $58.13 | $58.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.47 / $59.47 / $138.40
| Facility | | $59.47 | $59.47 | $138.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $59.47 / $103.13
| Professional | | $43.41 | $59.47 | $103.13 |
- 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
- $72.45 / $72.45 / $76.06
| Professional | | $72.45 | $72.45 | $76.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.52 / $58.52 / $71.23
| Facility | | $58.52 | $58.52 | $71.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.52 / $71.23 / $71.23
| Professional | | $58.52 | $71.23 | $71.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.37 / $422.04 / $422.04
| Facility | | $180.37 | $422.04 | $422.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.71 / $47.49 / $120.97
| Professional | | $34.71 | $47.49 | $120.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.42 / $76.37 / $131.79
| Professional | | $60.42 | $76.37 | $131.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.04 / $47.49 / $88.85
| Professional | | $36.04 | $47.49 | $88.85 |