- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $151.36 / $18,620.87
| Facility | | $28.84 | $151.36 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $39.81
| Professional | | $28.84 | $28.84 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.90
| Professional | | $30.20 | $30.20 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $64.57
| Facility | | $28.18 | $28.18 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $32.36
| Professional | | $30.20 | $30.20 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $138.04 / $338.84
| Facility | | $30.20 | $138.04 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $30.90 / $257.04
| Professional | | $25.70 | $30.90 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.90
| Facility | | $30.20 | $30.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.90 / $30.90
| Professional | | $30.20 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $67.61 / $8,317.64
| Facility | | $40.74 | $67.61 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $50,118.72 / $75,857.76
| Facility | | $38.90 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $33.11 / $33.11
| Professional | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $114.82 / $125.89
| Professional | | $29.51 | $114.82 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $33.11
| Facility | | $30.20 | $30.20 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.90 / $30.90
| Professional | | $30.20 | $30.90 | $30.90 |