- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.75 / $54.60 / $98.00
| Facility | | $29.75 | $54.60 | $98.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.85 / $28.86 / $52.50
| Professional | | $28.85 | $28.86 | $52.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.00 / $35.00 / $91.00
| Facility | | $35.00 | $35.00 | $91.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $15.47 / $51.35
| Professional | | $14.00 | $15.47 | $51.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.00 / $35.00 / $35.00
| Facility | | $21.00 | $35.00 | $35.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.55 / $35.00 / $35.00
| Professional | | $25.55 | $35.00 | $35.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.75 / $73.94 / $93.15
| Facility | | $42.75 | $73.94 | $93.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.25 / $54.20 / $113.31
| Professional | | $21.25 | $54.20 | $113.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.00 / $73.50 / $332.00
| Facility | | $35.00 | $73.50 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.50 / $36.75 / $65.45
| Professional | | $24.50 | $36.75 | $65.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.00 / $33.25 / $62.42
| Professional | | $28.00 | $33.25 | $62.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.13 / $85.13 / $254.50
| Facility | | $34.13 | $85.13 | $254.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.17 / $61.25 / $105.00
| Professional | | $22.17 | $61.25 | $105.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.70 / $21.00 / $53.05
| Professional | | $14.70 | $21.00 | $53.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.10 / $37.10 / $37.10
| Facility | | $32.10 | $37.10 | $37.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.75 / $35.00 / $41.20
| Professional | | $29.75 | $35.00 | $41.20 |