- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.71 / $72.77 / $253.52
| Facility | | $50.71 | $72.77 | $253.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.70 / $51.98 / $70.69
| Professional | | $50.70 | $51.98 | $70.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.34 / $94.56 / $184.38
| Facility | | $37.34 | $94.56 | $184.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.51 / $36.51 / $36.51
| Professional | | $36.51 | $36.51 | $36.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.87 / $53.87 / $53.87
| Facility | | $53.87 | $53.87 | $53.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.87 / $53.87 / $53.87
| Professional | | $53.87 | $53.87 | $53.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $170.50 / $237.71
| Facility | | $75.00 | $170.50 | $237.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.88 / $22.60 / $74.31
| Facility | | $6.88 | $22.60 | $74.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $12.31 / $47.54
| Professional | | $6.42 | $12.31 | $47.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.84 / $53.87 / $74.33
| Facility | | $14.84 | $53.87 | $74.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $53.87 / $53.87
| Professional | | $12.31 | $53.87 | $53.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.41 / $111.41 / $111.41
| Facility | | $111.41 | $111.41 | $111.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.82 / $52.82 / $52.82
| Professional | | $52.82 | $52.82 | $52.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.83 / $52.83 / $71.31
| Professional | | $52.83 | $52.83 | $71.31 |