- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $60.26 / $177.83
| Facility | | $48.98 | $60.26 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $36.31 / $83.18
| Professional | | $28.84 | $36.31 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $102.33 / $123.03
| Facility | | $64.57 | $102.33 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $52.48 / $70.79
| Professional | | $34.67 | $52.48 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $85.11 / $104.71
| Professional | | $38.90 | $85.11 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $38.90 / $45.71
| Facility | | $38.90 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $38.90 / $54.95
| Professional | | $38.90 | $38.90 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $38.90 / $83.18
| Facility | | $38.90 | $38.90 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.48 / $54.95 / $114.82
| Facility | | $35.48 | $54.95 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $51.29 / $79.43
| Professional | | $38.90 | $51.29 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $114.82 / $154.88
| Facility | | $58.88 | $114.82 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $33.11 / $46.77
| Professional | | $31.62 | $33.11 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $46.77 / $63.10
| Facility | | $46.77 | $46.77 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $46.77
| Professional | | $16.60 | $16.60 | $46.77 |