- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.76 / $56.76 / $56.76
| Facility | | $56.76 | $56.76 | $56.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.55 / $56.76 / $73.14
| Professional | | $52.55 | $56.76 | $73.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.27 / $330.85 / $619.59
| Facility | | $81.27 | $330.85 | $619.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.79 / $81.27 / $126.88
| Professional | | $47.79 | $81.27 | $126.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.88 / $167.76 / $216.05
| Facility | | $137.88 | $167.76 | $216.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.06 / $108.17 / $108.17
| Professional | | $85.06 | $108.17 | $108.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.18 / $75.15 / $91.08
| Facility | | $72.18 | $75.15 | $91.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.69 / $72.18 / $113.25
| Professional | | $52.69 | $72.18 | $113.25 |
- 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
- $105.19 / $105.19 / $110.45
| Professional | | $105.19 | $105.19 | $110.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.16 / $72.16 / $72.16
| Facility | | $72.16 | $72.16 | $72.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.16 / $72.16 / $85.57
| Professional | | $72.16 | $72.16 | $85.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.85 / $619.59 / $619.59
| Facility | | $330.85 | $619.59 | $619.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.21 / $64.81 / $126.88
| Professional | | $43.21 | $64.81 | $126.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.24 / $116.24 / $117.98
| Professional | | $116.24 | $116.24 | $117.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.11 / $64.81 / $112.35
| Professional | | $44.11 | $64.81 | $112.35 |