- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.51 / $24.51 / $24.51
| Facility | | $24.51 | $24.51 | $24.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $24.51 / $40.46
| Professional | | $19.64 | $24.51 | $40.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.38 / $154.05 / $256.88
| Facility | | $48.38 | $154.05 | $256.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.52 / $41.82 / $52.81
| Professional | | $23.52 | $41.82 | $52.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.06 / $69.83 / $89.92
| Facility | | $58.06 | $69.83 | $89.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.21 / $41.60 / $41.60
| Professional | | $39.21 | $41.60 | $41.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.60 / $35.60 / $35.60
| Facility | | $35.60 | $35.60 | $35.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.99 / $35.59 / $62.63
| Professional | | $25.99 | $35.59 | $62.63 |
- 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
- $44.09 / $44.09 / $46.29
| Professional | | $44.09 | $44.09 | $46.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.23 / $71.23 / $106.86
| Facility | | $71.23 | $71.23 | $106.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.61 / $43.36 / $43.36
| Professional | | $35.61 | $43.36 | $43.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.78 / $256.88 / $256.88
| Facility | | $109.78 | $256.88 | $256.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $26.98 / $52.81
| Professional | | $19.60 | $26.98 | $52.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $31.36 / $54.08
| Professional | | $19.60 | $31.36 | $54.08 |