- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.02 / $22.45 / $22.89
| Facility | | $22.02 | $22.45 | $22.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.73 / $22.89 / $37.13
| Professional | | $20.73 | $22.89 | $37.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.42 / $29.36 / $29.36
| Professional | | $26.42 | $29.36 | $29.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.32 / $49.32 / $49.32
| Facility | | $49.32 | $49.32 | $49.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.38 / $27.38 / $27.38
| Facility | | $27.38 | $27.38 | $27.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $27.38
| Professional | | $19.98 | $19.98 | $27.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $228.34 / $228.34
| Facility | | $85.00 | $228.34 | $228.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.66 / $246.66 / $359.03
| Professional | | $246.66 | $246.66 | $359.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $32.95 / $49.32
| Facility | | $14.11 | $32.95 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.11 / $45.37 / $49.32
| Professional | | $14.11 | $45.37 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.72 / $49.32 / $113.20
| Professional | | $37.72 | $49.32 | $113.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $29.64 / $49.32
| Facility | | $14.11 | $29.64 | $49.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $28.20
| Professional | | $19.98 | $19.98 | $28.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $26.00 / $31.36
| Professional | | $18.11 | $26.00 | $31.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.27 / $26.70 / $49.32
| Professional | | $26.27 | $26.70 | $49.32 |