- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.72 / $703.35 / $1,218.36
| Facility | | $21.72 | $703.35 | $1,218.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $39.33 / $700.51
| Professional | | $18.11 | $39.33 | $700.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.69 / $19.64 / $8,639.91
| Facility | | $16.69 | $19.64 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.79 / $18.79 / $18.79
| Professional | | $18.79 | $18.79 | $18.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.07 / $18.11 / $18.11
| Facility | | $17.07 | $18.11 | $18.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $18.11 / $18.11
| Professional | | $18.11 | $18.11 | $18.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.03 / $42.20 / $64.06
| Facility | | $33.03 | $42.20 | $64.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.13 / $779.83 / $1,218.36
| Facility | | $23.13 | $779.83 | $1,218.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $39.33 / $691.41
| Professional | | $18.11 | $39.33 | $691.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.07 / $18.11 / $18.11
| Facility | | $17.07 | $18.11 | $18.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $18.11 / $18.11
| Professional | | $18.11 | $18.11 | $18.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $19.23
| Facility | | $16.57 | $16.57 | $19.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $19.23
| Professional | | $16.57 | $16.57 | $19.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.00 / $22.00 / $22.00
| Facility | | $22.00 | $22.00 | $22.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $18.11 / $23.63
| Professional | | $18.11 | $18.11 | $23.63 |