- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.50 / $62.50 / $98.16
| Facility | | $62.50 | $62.50 | $98.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.13 / $69.52 / $108.68
| Professional | | $56.13 | $69.52 | $108.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.50 / $346.40 / $851.77
| Facility | | $82.50 | $346.40 | $851.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.43 / $108.91 / $139.68
| Professional | | $64.43 | $108.91 | $139.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.82 / $184.70 / $237.86
| Facility | | $151.82 | $184.70 | $237.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.54 / $133.16 / $184.71
| Professional | | $92.54 | $133.16 | $184.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.73 / $105.13 / $115.38
| Facility | | $82.73 | $105.13 | $115.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.23 / $115.38 / $175.69
| Professional | | $84.23 | $115.38 | $175.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.80 / $115.80 / $121.59
| Professional | | $115.80 | $115.80 | $121.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.80 / $82.80 / $98.11
| Facility | | $82.80 | $82.80 | $98.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.79 / $80.79 / $80.79
| Professional | | $80.79 | $80.79 | $80.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.40 / $851.77 / $851.77
| Facility | | $346.40 | $851.77 | $851.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.98 / $76.45 / $139.68
| Professional | | $54.98 | $76.45 | $139.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.48 / $109.19 / $137.74
| Professional | | $64.48 | $109.19 | $137.74 |