- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.52 / $150.52 / $334.35
| Facility | | $150.52 | $150.52 | $334.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.52 / $150.52 / $150.52
| Professional | | $150.52 | $150.52 | $150.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.38 / $41.53 / $130.18
| Facility | | $40.38 | $41.53 | $130.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.65 / $50.76 / $86.27
| Professional | | $21.65 | $50.76 | $86.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.25 / $54.34 / $191.36
| Facility | | $47.25 | $54.34 | $191.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.24 / $52.35 / $453.54
| Professional | | $49.24 | $52.35 | $453.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.85 / $19.85 / $28.35
| Professional | | $19.85 | $19.85 | $28.35 |