- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.14 / $25.14 / $77.59
| Facility | | $25.14 | $25.14 | $77.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.14 / $30.17 / $65.11
| Professional | | $25.14 | $30.17 | $65.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.22 / $141.61 / $334.02
| Facility | | $38.22 | $141.61 | $334.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.32 / $41.84 / $56.18
| Professional | | $25.32 | $41.84 | $56.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.06 / $74.29 / $95.67
| Facility | | $61.06 | $74.29 | $95.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $38.90 / $39.47
| Professional | | $36.31 | $38.90 | $39.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.61 / $36.61 / $36.61
| Facility | | $36.61 | $36.61 | $36.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.73 / $36.61 / $83.63
| Professional | | $26.73 | $36.61 | $83.63 |
- 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
- $46.59 / $46.59 / $48.92
| Professional | | $46.59 | $46.59 | $48.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.78 / $75.78 / $75.78
| Facility | | $75.78 | $75.78 | $75.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.25 / $38.25 / $38.25
| Professional | | $38.25 | $38.25 | $38.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.22 / $334.02 / $334.02
| Facility | | $146.22 | $334.02 | $334.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.90 / $29.29 / $56.18
| Professional | | $21.90 | $29.29 | $56.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.47 / $29.55 / $54.42
| Professional | | $22.47 | $29.55 | $54.42 |