- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.56 / $68.56 / $68.56
| Facility | | $68.56 | $68.56 | $68.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.46 / $68.56 / $88.35
| Professional | | $57.46 | $68.56 | $88.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.10 / $305.13 / $469.03
| Facility | | $92.10 | $305.13 | $469.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.97 / $90.90 / $116.56
| Professional | | $53.97 | $90.90 | $116.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.35 / $202.64 / $260.97
| Facility | | $171.35 | $202.64 | $260.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.74 / $106.12 / $106.12
| Professional | | $102.74 | $106.12 | $106.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.68 / $76.68 / $115.32
| Facility | | $76.68 | $76.68 | $115.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.98 / $76.68 / $111.38
| Professional | | $55.98 | $76.68 | $111.38 |
- 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
- $127.06 / $127.06 / $133.41
| Professional | | $127.06 | $127.06 | $133.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.11 / $79.11 / $79.11
| Professional | | $79.11 | $79.11 | $79.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.74 / $469.03 / $469.03
| Facility | | $197.74 | $469.03 | $469.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.39 / $78.29 / $121.60
| Professional | | $51.39 | $78.29 | $121.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.11 / $71.01 / $76.23
| Facility | | $0.11 | $71.01 | $76.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.19 / $78.29 / $127.06
| Professional | | $52.19 | $78.29 | $127.06 |