- 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
- $28.18 / $36.31 / $95.50
| Professional | | $28.18 | $36.31 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $70.79 / $436.52
| Facility | | $61.66 | $70.79 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $52.48 / $70.79
| Professional | | $30.90 | $52.48 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $120.23
| Facility | | $39.81 | $39.81 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $57.54 / $57.54
| Professional | | $44.67 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $42.66 / $47.86
| Facility | | $39.81 | $42.66 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $42.66
| Professional | | $30.90 | $30.90 | $42.66 |
- 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
- $60.26 / $60.26 / $91.20
| Professional | | $60.26 | $60.26 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $43.65
| Professional | | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $70.79 / $436.52
| Facility | | $61.66 | $70.79 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $52.48 / $85.11
| Professional | | $30.90 | $52.48 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $43.65 / $93.33
| Facility | | $0.05 | $43.65 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $40.74 / $60.26
| Professional | | $28.18 | $40.74 | $60.26 |