- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $60.26 / $131.83
| Facility | | $45.71 | $60.26 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $79.43 / $8,128.31
| Professional | | $44.67 | $79.43 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $47.86
| Facility | | $45.71 | $45.71 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $45.71
| Professional | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $39.81
| Facility | | $37.15 | $37.15 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $37.15
| Professional | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $42.66 / $85.11
| Facility | | $39.81 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $190.55
| Professional | | $45.71 | $45.71 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $51.29 / $141.25
| Facility | | $39.81 | $51.29 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $64.57
| Professional | | $43.65 | $43.65 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $46.77
| Facility | | $44.67 | $44.67 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $45.71
| Professional | | $44.67 | $44.67 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $56.23 / $100.00
| Facility | | $56.23 | $56.23 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $50,118.72 / $75,857.76
| Facility | | $52.48 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $45.71 / $63.10
| Professional | | $40.74 | $45.71 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $51.29
| Facility | | $44.67 | $44.67 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $44.67 / $53.70
| Professional | | $22.91 | $44.67 | $53.70 |