- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.26 / $38.47 / $78.65
| Facility | | $13.26 | $38.47 | $78.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.91 / $42.80 / $167.13
| Professional | | $21.91 | $42.80 | $167.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $165.21 / $418.29
| Facility | | $55.00 | $165.21 | $418.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.27 / $55.00 / $86.00
| Professional | | $32.27 | $55.00 | $86.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.47 / $113.72 / $146.44
| Facility | | $93.47 | $113.72 | $146.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.41 / $64.76 / $90.79
| Professional | | $42.41 | $64.76 | $90.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.70 / $50.94 / $61.74
| Facility | | $45.70 | $50.94 | $61.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.10 / $33.36 / $93.38
| Professional | | $30.10 | $33.36 | $93.38 |
- 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
- $71.30 / $71.30 / $74.86
| Professional | | $71.30 | $71.30 | $74.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.52 / $38.52 / $38.52
| Facility | | $38.52 | $38.52 | $38.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.52 / $46.25 / $47.30
| Professional | | $38.52 | $46.25 | $47.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.19 / $418.29 / $418.29
| Facility | | $163.19 | $418.29 | $418.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.29 / $43.93 / $86.00
| Professional | | $29.29 | $43.93 | $86.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.90 / $59.90 / $68.73
| Professional | | $59.90 | $59.90 | $68.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.29 / $43.93 / $88.06
| Professional | | $29.29 | $43.93 | $88.06 |