- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.17 / $11.80 / $12.23
| Facility | | $11.17 | $11.80 | $12.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.31 / $12.03 / $17.32
| Professional | | $10.31 | $12.03 | $17.32 |
- 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
- $18.00 / $18.00 / $22.50
| Professional | | $18.00 | $18.00 | $22.50 |
- 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
- $28.09 / $28.09 / $28.09
| Facility | | $28.09 | $28.09 | $28.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.51 / $20.51 / $28.09
| Professional | | $20.51 | $20.51 | $28.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.05 / $119.23 / $119.23
| Facility | | $115.05 | $119.23 | $119.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $161.69 / $183.90
| Professional | | $155.47 | $161.69 | $183.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $19.87 / $36.33
| Facility | | $10.81 | $19.87 | $36.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $10.81 / $19.87
| Professional | | $9.30 | $10.81 | $19.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.06 / $79.78 / $81.79
| Professional | | $76.06 | $79.78 | $81.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $19.87 / $34.77
| Facility | | $10.81 | $19.87 | $34.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.51 / $20.51 / $28.09
| Professional | | $20.51 | $20.51 | $28.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $13.97 / $26.09
| Professional | | $11.73 | $13.97 | $26.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.20 / $54.93 / $54.93
| Professional | | $32.20 | $54.93 | $54.93 |