- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.47 / $54.47 / $84.15
| Facility | | $54.47 | $54.47 | $84.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.35 / $60.59 / $221.22
| Professional | | $41.35 | $60.59 | $221.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.06 / $274.68 / $789.50
| Facility | | $64.06 | $274.68 | $789.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.16 / $94.92 / $121.74
| Professional | | $56.16 | $94.92 | $121.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.32 / $160.97 / $207.31
| Facility | | $132.32 | $160.97 | $207.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.31 / $124.14 / $168.28
| Professional | | $84.31 | $124.14 | $168.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.04 / $86.64 / $91.63
| Facility | | $72.04 | $86.64 | $91.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.25 / $86.64 / $133.76
| Professional | | $63.25 | $86.64 | $133.76 |
- 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
- $100.93 / $100.93 / $105.98
| Professional | | $100.93 | $100.93 | $105.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.81 / $75.81 / $75.81
| Facility | | $75.81 | $75.81 | $75.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.95 / $75.81 / $75.81
| Professional | | $66.95 | $75.81 | $75.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.68 / $789.50 / $789.50
| Facility | | $274.68 | $789.50 | $789.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.92 / $64.56 / $121.74
| Professional | | $47.92 | $64.56 | $121.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.53 / $66.64 / $140.40
| Professional | | $51.53 | $66.64 | $140.40 |