- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.83 / $15.83 / $15.83
| Facility | | $15.83 | $15.83 | $15.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $15.83 / $26.34
| Professional | | $11.75 | $15.83 | $26.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.42 / $107.41 / $172.14
| Facility | | $32.42 | $107.41 | $172.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $27.86 / $36.81
| Professional | | $16.27 | $27.86 | $36.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.56 / $46.79 / $60.26
| Facility | | $39.56 | $46.79 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.74 / $24.85 / $24.85
| Professional | | $23.74 | $24.85 | $24.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.26 / $24.26 / $24.26
| Facility | | $24.26 | $24.26 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.71 / $24.26 / $42.00
| Professional | | $17.71 | $24.26 | $42.00 |
- 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
- $29.55 / $29.55 / $31.03
| Professional | | $29.55 | $29.55 | $31.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.61 / $71.61 / $87.18
| Facility | | $71.61 | $71.61 | $87.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.87 / $29.06 / $29.06
| Professional | | $23.87 | $29.06 | $29.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.56 / $172.14 / $172.14
| Facility | | $73.56 | $172.14 | $172.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.16 / $19.38 / $49.34
| Professional | | $14.16 | $19.38 | $49.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.16 / $32.42 / $32.42
| Professional | | $31.16 | $32.42 | $32.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.16 / $19.38 / $36.24
| Professional | | $14.16 | $19.38 | $36.24 |