- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $144.54 / $3,162.28
| Facility | | $21.88 | $144.54 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $93.33
| Professional | | $8.91 | $8.91 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $74.13
| Professional | | $5.01 | $5.01 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $134.90 / $213.80
| Facility | | $74.13 | $134.90 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $95.50 / $165.96
| Professional | | $70.79 | $95.50 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Professional | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $41.69 / $48.98
| Professional | | $41.69 | $41.69 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $257.04 / $831.76
| Professional | | $45.71 | $257.04 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $707.95
| Facility | | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Professional | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $12.02 / $95.50
| Facility | | $9.55 | $12.02 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Professional | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $48.98 / $70.79
| Professional | | $41.69 | $48.98 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $114.82 / $177.83
| Facility | | $112.20 | $114.82 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $53.70
| Professional | | $31.62 | $31.62 | $53.70 |