- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $28.18 / $537.03
| Facility | | $25.70 | $28.18 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $39.81 / $61.66
| Professional | | $28.18 | $39.81 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $67.61 / $309.03
| Facility | | $54.95 | $67.61 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $51.29 / $93.33
| Professional | | $26.30 | $51.29 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $85.11 / $114.82
| Facility | | $74.13 | $85.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $41.69
| Professional | | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $39.81 / $48.98
| Facility | | $38.02 | $39.81 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $48.98
| Professional | | $33.88 | $33.88 | $48.98 |
- 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
- $57.54 / $57.54 / $87.10
| Professional | | $57.54 | $57.54 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $39.81
| Professional | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $67.61 / $309.03
| Facility | | $54.95 | $67.61 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $52.48 / $95.50
| Professional | | $26.30 | $52.48 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.04 / $25.70 / $41.69
| Facility | | $0.04 | $25.70 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $38.02 / $61.66
| Professional | | $25.70 | $38.02 | $61.66 |