- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.67 / $24.67 / $24.67
| Facility | | $24.67 | $24.67 | $24.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.67 / $24.67 / $39.27
| Professional | | $24.67 | $24.67 | $39.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.26 / $126.07 / $317.87
| Facility | | $46.26 | $126.07 | $317.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.04 / $42.84 / $57.34
| Professional | | $25.04 | $42.84 | $57.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.20 / $84.19 / $107.94
| Facility | | $69.20 | $84.19 | $107.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.97 / $49.18 / $49.18
| Professional | | $36.97 | $49.18 | $49.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.65 / $34.77 / $39.58
| Facility | | $32.65 | $34.77 | $39.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.38 / $25.38 / $65.25
| Professional | | $25.38 | $25.38 | $65.25 |
- 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
- $45.70 / $45.70 / $47.98
| Professional | | $45.70 | $45.70 | $47.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.58 / $64.58 / $64.58
| Facility | | $64.58 | $64.58 | $64.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.29 / $32.29 / $37.18
| Professional | | $32.29 | $32.29 | $37.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.07 / $317.87 / $317.87
| Facility | | $126.07 | $317.87 | $317.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.05 / $30.18 / $55.13
| Professional | | $22.05 | $30.18 | $55.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.52 / $33.09 / $55.13
| Professional | | $24.52 | $33.09 | $55.13 |