- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.03 / $39.03 / $39.03
| Facility | | $39.03 | $39.03 | $39.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.46 / $39.03 / $58.42
| Professional | | $37.46 | $39.03 | $58.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.93 / $152.97 / $400.57
| Facility | | $50.93 | $152.97 | $400.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.07 / $55.19 / $87.21
| Professional | | $34.07 | $55.19 | $87.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.66 / $51.66 / $153.43
| Facility | | $51.66 | $51.66 | $153.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.49 / $62.41 / $62.41
| Professional | | $58.49 | $62.41 | $62.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.58 / $51.66 / $62.61
| Facility | | $43.58 | $51.66 | $62.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.81 / $43.58 / $84.38
| Professional | | $31.81 | $43.58 | $84.38 |
- 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
- $72.31 / $72.31 / $75.93
| Professional | | $72.31 | $72.31 | $75.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.65 / $51.65 / $51.65
| Professional | | $51.65 | $51.65 | $51.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.94 / $400.57 / $400.57
| Facility | | $147.94 | $400.57 | $400.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.70 / $44.56 / $87.21
| Professional | | $29.70 | $44.56 | $87.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.00 / $44.00 / $44.00
| Facility | | $44.00 | $44.00 | $44.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.60 / $44.56 / $74.87
| Professional | | $31.60 | $44.56 | $74.87 |