- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $37.15
| Facility | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $45.71 / $120.23
| Professional | | $34.67 | $45.71 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $89.13 / $549.54
| Facility | | $77.62 | $89.13 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $67.61 / $89.13
| Professional | | $38.90 | $67.61 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $112.20 / $147.91
| Facility | | $93.33 | $112.20 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $72.44 / $72.44
| Professional | | $56.23 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $53.70 / $60.26
| Facility | | $50.12 | $53.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $63.10
| Professional | | $39.81 | $39.81 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $75.86 / $114.82
| Professional | | $75.86 | $75.86 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Professional | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $89.13 / $549.54
| Facility | | $77.62 | $89.13 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $67.61 / $97.72
| Professional | | $38.90 | $67.61 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.07 / $54.95 / $117.49
| Facility | | $0.07 | $54.95 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $51.29 / $75.86
| Professional | | $36.31 | $51.29 | $75.86 |