- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $144.54 / $467.74
| Facility | | $63.10 | $144.54 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $77.62 / $154.88
| Professional | | $39.81 | $77.62 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $47.86 / $81.28
| Professional | | $33.11 | $47.86 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $70.79 / $95.50
| Facility | | $60.26 | $70.79 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $89.13 / $107.15 / $144.54
| Facility | 50 | $89.13 | $107.15 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $53.70 / $83.18
| Professional | | $38.02 | $53.70 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $67.61 / $67.61
| Facility | | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $66.07 / $144.54
| Professional | | $38.90 | $66.07 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $562.34 / $1,548.82
| Facility | | $218.78 | $562.34 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $53.70 / $97.72
| Professional | | $32.36 | $53.70 | $97.72 |