- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $37.15 / $66.07
| Facility | | $28.84 | $37.15 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.84 / $38.02
| Professional | | $28.18 | $28.84 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $29.51
| Facility | | $28.84 | $28.84 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $61.66
| Facility | | $26.92 | $26.92 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $32.36
| Professional | | $28.84 | $28.84 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $34.67 / $97.72
| Facility | | $26.92 | $34.67 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $37.15
| Professional | | $28.84 | $28.84 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $29.51
| Facility | | $28.84 | $28.84 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $29.51 / $29.51
| Professional | | $28.84 | $29.51 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $50,118.72 / $75,857.76
| Facility | | $36.31 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $53.70 / $53.70
| Professional | | $53.70 | $53.70 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $28.84
| Facility | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $30.20 / $38.02
| Professional | | $26.92 | $30.20 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $33.88
| Facility | | $28.84 | $28.84 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $29.51 / $29.51
| Professional | | $28.84 | $29.51 | $29.51 |