- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.94 / $62.94 / $62.94
| Facility | | $62.94 | $62.94 | $62.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.94 / $70.01 / $92.25
| Professional | | $62.94 | $70.01 | $92.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.87 / $410.31 / $688.05
| Facility | | $128.87 | $410.31 | $688.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.33 / $109.68 / $140.66
| Professional | | $65.33 | $109.68 | $140.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.38 / $97.42 / $97.42
| Professional | | $69.38 | $97.42 | $97.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.71 / $83.71 / $83.71
| Facility | | $83.71 | $83.71 | $83.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.93 / $83.71 / $171.00
| Professional | | $38.93 | $83.71 | $171.00 |
- 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
- $116.62 / $116.62 / $122.45
| Professional | | $116.62 | $116.62 | $122.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.00 / $49.00 / $49.00
| Facility | | $49.00 | $49.00 | $49.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.31 / $65.31 / $65.31
| Professional | | $65.31 | $65.31 | $65.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.55 / $688.05 / $688.05
| Facility | | $299.55 | $688.05 | $688.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.71 / $73.28 / $140.66
| Professional | | $51.71 | $73.28 | $140.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.11 / $65.33 / $76.31
| Facility | | $0.11 | $65.33 | $76.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.88 / $82.26 / $144.04
| Professional | | $56.88 | $82.26 | $144.04 |