- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.18 / $238.96 / $367.56
| Facility | | $71.18 | $238.96 | $367.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.68 / $71.18 / $362.94
| Professional | | $57.68 | $71.18 | $362.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.80 / $421.78 / $8,639.91
| Facility | | $324.80 | $421.78 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.55 / $68.55 / $68.55
| Professional | | $68.55 | $68.55 | $68.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.76 / $114.24 / $291.20
| Facility | | $57.76 | $114.24 | $291.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.38 / $99.08 / $131.27
| Professional | | $40.38 | $99.08 | $131.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.88 / $51.85 / $118.99
| Professional | | $37.88 | $51.85 | $118.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.10 / $477.10 / $477.10
| Facility | | $477.10 | $477.10 | $477.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.70 / $238.96 / $367.56
| Facility | | $74.70 | $238.96 | $367.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.60 / $72.06 / $362.94
| Professional | | $59.60 | $72.06 | $362.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.83 / $117.02 / $291.20
| Facility | | $58.83 | $117.02 | $291.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.38 / $99.08 / $126.48
| Professional | | $40.38 | $99.08 | $126.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.88 / $87.88 / $87.88
| Facility | | $87.88 | $87.88 | $87.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.33 / $87.88 / $91.68
| Professional | | $77.33 | $87.88 | $91.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.79 / $52.73 / $149.40
| Professional | | $37.79 | $52.73 | $149.40 |