- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.45 / $61.66 / $79.45
| Professional | | $54.45 | $61.66 | $79.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.09 / $278.58 / $670.32
| Facility | | $80.09 | $278.58 | $670.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.70 / $84.87 / $137.81
| Professional | | $51.70 | $84.87 | $137.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.62 / $81.62 / $242.41
| Facility | | $81.62 | $81.62 | $242.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.41 / $117.48 / $117.48
| Professional | | $92.41 | $117.48 | $117.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.45 / $81.62 / $98.93
| Facility | | $68.45 | $81.62 | $98.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.98 / $68.45 / $122.63
| Professional | | $49.98 | $68.45 | $122.63 |
- 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
- $114.26 / $114.26 / $119.97
| Professional | | $114.26 | $114.26 | $119.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.89 / $69.89 / $69.89
| Professional | | $69.89 | $69.89 | $69.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.58 / $670.32 / $670.32
| Facility | | $278.58 | $670.32 | $670.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.94 / $70.40 / $137.81
| Professional | | $46.94 | $70.40 | $137.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.12 / $141.12 / $141.12
| Facility | | $141.12 | $141.12 | $141.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.94 / $70.40 / $130.33
| Professional | | $46.94 | $70.40 | $130.33 |