- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $186.21 / $851.14
| Facility | | $75.86 | $186.21 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $44.67 / $371.54 / $371.54
| Facility | 50 | $44.67 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $75.86 / $208.93
| Professional | | $35.48 | $75.86 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.44 / $144.54 / $331.13
| Professional | 50 | $72.44 | $144.54 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $39.81 / $51.29
| Professional | | $36.31 | $39.81 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $331.13
| Facility | | $26.92 | $26.92 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $54.95 / $107.15
| Professional | | $35.48 | $54.95 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $67.61 / $102.33
| Professional | | $58.88 | $67.61 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $40.74 / $47.86
| Facility | | $33.88 | $40.74 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $51.29 / $91.20
| Professional | | $33.11 | $51.29 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $67.61 / $85.11
| Professional | | $52.48 | $67.61 | $85.11 |