- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.87 / $55.87 / $81.04
| Facility | | $55.87 | $55.87 | $81.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.01 / $57.60 / $83.51
| Professional | | $55.01 | $57.60 | $83.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.10 / $288.64 / $474.60
| Facility | | $96.10 | $288.64 | $474.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.04 / $91.52 / $124.86
| Professional | | $25.04 | $91.52 | $124.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.97 / $164.99 / $211.67
| Facility | | $134.97 | $164.99 | $211.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.26 / $27.26 / $86.46
| Professional | | $27.26 | $27.26 | $86.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.19 / $59.92 / $59.92
| Facility | | $29.19 | $59.92 | $59.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.74 / $55.92 / $122.63
| Professional | | $43.74 | $55.92 | $122.63 |
- 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
- $103.51 / $103.51 / $108.69
| Professional | | $103.51 | $103.51 | $108.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $25.37
| Professional | | $25.37 | $25.37 | $25.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.02 / $474.60 / $474.60
| Facility | | $215.02 | $474.60 | $474.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.26 / $60.05 / $124.86
| Professional | | $22.26 | $60.05 | $124.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.26 / $62.43 / $103.51
| Professional | | $22.26 | $62.43 | $103.51 |