- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.77 / $70.01 / $90.96
| Facility | | $26.77 | $70.01 | $90.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.51 / $26.76 / $33.40
| Professional | | $26.51 | $26.76 | $33.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.10 / $28.23 / $8,459.92
| Facility | | $24.10 | $28.23 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.00 / $27.00 / $27.00
| Professional | | $27.00 | $27.00 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.83 / $26.51 / $26.51
| Facility | | $20.83 | $26.51 | $26.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.51 / $26.51 / $26.51
| Professional | | $26.51 | $26.51 | $26.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.26 / $26.51 / $43.27
| Professional | | $26.26 | $26.51 | $43.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.12 / $96.12 / $96.12
| Facility | | $96.12 | $96.12 | $96.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.46 / $37.46 / $41.64
| Professional | | $37.46 | $37.46 | $41.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.22 / $46.68 / $90.96
| Facility | | $30.22 | $46.68 | $90.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.51 / $29.00 / $45.33
| Professional | | $26.51 | $29.00 | $45.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $41.79 / $144.69
| Professional | | $27.40 | $41.79 | $144.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.83 / $26.51 / $26.51
| Facility | | $20.83 | $26.51 | $26.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.51 / $26.51 / $26.51
| Professional | | $26.51 | $26.51 | $26.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.75 / $49.75 / $57.73
| Facility | | $49.75 | $49.75 | $57.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.75 / $49.75 / $57.73
| Professional | | $49.75 | $49.75 | $57.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.51 / $28.10 / $39.77
| Professional | | $26.51 | $28.10 | $39.77 |