- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.28 / $50.89 / $72.56
| Facility | | $36.28 | $50.89 | $72.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $43.51
| Professional | | $36.28 | $36.28 | $43.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.04 / $97.23 / $181.40
| Facility | | $32.04 | $97.23 | $181.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.35 / $156.44
| Professional | | $36.28 | $36.35 | $156.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.89 / $44.55 / $86.56
| Facility | | $38.89 | $44.55 | $86.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $59.68 / $75.34
| Professional | | $36.28 | $59.68 | $75.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.44 / $36.28 / $36.28
| Facility | | $35.44 | $36.28 | $36.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $36.28
| Professional | | $36.28 | $36.28 | $36.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.99 / $72.52 / $8,090.00
| Facility | | $36.99 | $72.52 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $36.28
| Professional | | $36.28 | $36.28 | $36.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $36.28 / $41.99
| Professional | | $36.28 | $36.28 | $41.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.44 / $1,591.44 / $1,591.44
| Facility | | $1,591.44 | $1,591.44 | $1,591.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $181.40 / $181.40
| Facility | | $75.00 | $181.40 | $181.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $38.46 / $156.44
| Professional | | $36.28 | $38.46 | $156.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.44 / $39.52 / $57.77
| Facility | | $35.44 | $39.52 | $57.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.28 / $38.09 / $46.99
| Professional | | $36.28 | $38.09 | $46.99 |