- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.82 / $34.82 / $52.23
| Facility | | $34.82 | $34.82 | $52.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.04 / $34.82 / $37.00
| Professional | | $30.04 | $34.82 | $37.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.07 / $24.07 / $30.09
| Facility | | $24.07 | $24.07 | $30.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.10 / $39.90 / $39.90
| Professional | | $30.10 | $39.90 | $39.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.71 / $40.71 / $40.71
| Facility | | $40.71 | $40.71 | $40.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.71 / $40.71 / $40.71
| Professional | | $40.71 | $40.71 | $40.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.39 / $46.84 / $332.00
| Facility | | $28.39 | $46.84 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.71 / $40.71 / $50.76
| Professional | | $40.71 | $40.71 | $50.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.28 / $38.45 / $38.45
| Facility | | $36.28 | $38.45 | $38.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $38.45 / $38.45
| Professional | | $36.28 | $38.45 | $38.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.71 / $555.00 / $74,999.25
| Facility | | $40.71 | $555.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.81 / $40.71 / $50.28
| Professional | | $32.81 | $40.71 | $50.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.90 / $39.90 / $53.86
| Professional | | $39.90 | $39.90 | $53.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $36.28
| Facility | | $36.28 | $36.28 | $36.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $38.45
| Professional | | $36.28 | $36.28 | $38.45 |