- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.91 / $29.91 / $29.91
| Facility | | $29.91 | $29.91 | $29.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.91 / $32.97 / $43.00
| Professional | | $29.91 | $32.97 | $43.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.38 / $193.15 / $433.53
| Facility | | $37.38 | $193.15 | $433.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.83 / $52.12 / $66.84
| Professional | | $30.83 | $52.12 | $66.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.59 / $39.59 / $117.58
| Facility | | $39.59 | $39.59 | $117.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.82 / $56.99 / $56.99
| Professional | | $44.82 | $56.99 | $56.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.59 / $42.77 / $47.98
| Facility | | $39.59 | $42.77 | $47.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.22 / $42.77 / $79.50
| Professional | | $31.22 | $42.77 | $79.50 |
- 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
- $55.42 / $55.42 / $58.19
| Professional | | $55.42 | $55.42 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.48 / $43.48 / $43.48
| Professional | | $43.48 | $43.48 | $43.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.94 / $433.53 / $433.53
| Facility | | $201.94 | $433.53 | $433.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.31 / $36.58 / $66.84
| Professional | | $26.31 | $36.58 | $66.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $33.85 / $38.72
| Facility | | $0.05 | $33.85 | $38.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.74 / $36.58 / $66.84
| Professional | | $26.74 | $36.58 | $66.84 |