- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.87 / $55.87 / $55.87
| Facility | | $55.87 | $55.87 | $55.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.87 / $60.04 / $86.49
| Professional | | $55.87 | $60.04 | $86.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.39 / $168.47 / $474.60
| Facility | | $53.39 | $168.47 | $474.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.63 / $85.07 / $124.86
| Professional | | $47.63 | $85.07 | $124.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.00 / $68.00 / $201.96
| Facility | | $68.00 | $68.00 | $201.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.71 / $119.51 / $158.07
| Professional | | $82.71 | $119.51 | $158.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.32 / $61.21 / $61.21
| Facility | | $60.32 | $61.21 | $61.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.68 / $60.32 / $122.63
| Professional | | $44.68 | $60.32 | $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
- Facility
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $25.37
| Facility | | $25.37 | $25.37 | $25.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $25.37 / $80.06
| Professional | | $25.37 | $25.37 | $80.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $474.60 / $474.60
| Facility | | $100.00 | $474.60 | $474.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.52 / $63.79 / $124.86
| Professional | | $42.52 | $63.79 | $124.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.86 / $127.86 / $127.86
| Facility | | $127.86 | $127.86 | $127.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.52 / $63.79 / $103.51
| Professional | | $42.52 | $63.79 | $103.51 |