- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.42 / $44.42 / $44.42
| Facility | | $44.42 | $44.42 | $44.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.19 / $44.42 / $57.24
| Professional | | $39.19 | $44.42 | $57.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $286.86 / $482.89
| Facility | | $95.50 | $286.86 | $482.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.25 / $77.15 / $101.06
| Professional | | $37.25 | $77.15 | $101.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.80 / $58.80 / $174.64
| Facility | | $58.80 | $58.80 | $174.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.56 / $66.56 / $84.65
| Professional | | $66.56 | $66.56 | $84.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.11 / $58.80 / $71.27
| Facility | | $54.11 | $58.80 | $71.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.50 / $54.11 / $88.50
| Professional | | $39.50 | $54.11 | $88.50 |
- 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
- $82.31 / $82.31 / $86.43
| Professional | | $82.31 | $82.31 | $86.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.32 / $154.32 / $154.32
| Facility | | $154.32 | $154.32 | $154.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.43 / $51.43 / $51.43
| Professional | | $51.43 | $51.43 | $51.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.04 / $482.89 / $482.89
| Facility | | $158.04 | $482.89 | $482.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.81 / $50.72 / $99.28
| Professional | | $33.81 | $50.72 | $99.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.00 / $48.00 / $48.00
| Facility | | $48.00 | $48.00 | $48.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.81 / $50.72 / $91.78
| Professional | | $33.81 | $50.72 | $91.78 |