- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.70 / $23.14 / $23.59
| Facility | | $22.70 | $23.14 | $23.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.36 / $23.59 / $38.27
| Professional | | $21.36 | $23.59 | $38.27 |
- 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
- $24.19 / $24.19 / $24.19
| Professional | | $24.19 | $24.19 | $24.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.82 / $50.82 / $50.82
| Facility | | $50.82 | $50.82 | $50.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.84 / $33.84 / $33.84
| Facility | | $33.84 | $33.84 | $33.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.70 / $24.70 / $33.84
| Professional | | $24.70 | $24.70 | $33.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $235.40 / $235.40
| Facility | | $85.00 | $235.40 | $235.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.43 / $254.43 / $370.05
| Professional | | $254.43 | $254.43 | $370.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.54 / $33.95 / $50.82
| Facility | | $14.54 | $33.95 | $50.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.54 / $43.20 / $50.82
| Professional | | $14.54 | $43.20 | $50.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.88 / $51.84 / $114.34
| Professional | | $38.88 | $51.84 | $114.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.54 / $33.84 / $50.82
| Facility | | $14.54 | $33.84 | $50.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.70 / $24.70 / $34.86
| Professional | | $24.70 | $24.70 | $34.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.78 / $26.04 / $32.32
| Professional | | $18.78 | $26.04 | $32.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.06 / $27.52 / $50.82
| Professional | | $27.06 | $27.52 | $50.82 |