- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.47 / $16.94 / $51.34
| Facility | | $15.47 | $16.94 | $51.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.28 / $16.66 / $24.00
| Professional | | $14.28 | $16.66 | $24.00 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.94 / $54.94 / $54.94
| Facility | | $54.94 | $54.94 | $54.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.11 / $40.11 / $54.94
| Professional | | $40.11 | $40.11 | $54.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.28 / $165.11 / $165.11
| Facility | | $159.28 | $165.11 | $165.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.02 / $220.50 / $254.55
| Professional | | $212.02 | $220.50 | $254.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.04 / $27.51 / $50.39
| Facility | | $15.04 | $27.51 | $50.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.87 / $15.04 / $27.51
| Professional | | $12.87 | $15.04 | $27.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $74.97 / $76.88
| Professional | | $26.30 | $74.97 | $76.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.04 / $27.51 / $54.94
| Facility | | $15.04 | $27.51 | $54.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.11 / $40.11 / $54.94
| Professional | | $40.11 | $40.11 | $54.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $19.34 / $36.22
| Professional | | $16.23 | $19.34 | $36.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.64 / $67.64 / $78.42
| Professional | | $67.64 | $67.64 | $78.42 |