- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.11 / $64.11 / $64.11
| Facility | | $64.11 | $64.11 | $64.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.11 / $64.11 / $111.06
| Professional | | $64.11 | $64.11 | $111.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.69 / $417.98 / $696.97
| Facility | | $98.69 | $417.98 | $696.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.32 / $103.62 / $149.02
| Professional | | $57.32 | $103.62 | $149.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.18 / $100.18 / $297.52
| Facility | | $100.18 | $100.18 | $297.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.64 / $94.03 / $94.03
| Professional | | $92.64 | $94.03 | $94.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.14 / $88.15 / $88.15
| Facility | | $80.14 | $88.15 | $88.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.93 / $88.15 / $170.25
| Professional | | $74.93 | $88.15 | $170.25 |
- 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
- $119.66 / $119.66 / $125.64
| Professional | | $119.66 | $119.66 | $125.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.13 / $70.13 / $70.13
| Professional | | $70.13 | $70.13 | $70.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.86 / $696.97 / $696.97
| Facility | | $297.86 | $696.97 | $696.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.80 / $73.20 / $199.81
| Professional | | $48.80 | $73.20 | $199.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.95 / $57.04 / $82.22
| Facility | | $47.95 | $57.04 | $82.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.80 / $74.02 / $146.72
| Professional | | $48.80 | $74.02 | $146.72 |