- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.70 / $121.61 / $179.15
| Facility | | $34.70 | $121.61 | $179.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.15 / $35.13 / $275.45
| Professional | | $33.15 | $35.13 | $275.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.01 / $287.83 / $8,459.92
| Facility | | $216.01 | $287.83 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.42 / $33.42 / $33.42
| Professional | | $33.42 | $33.42 | $33.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.65 / $63.37 / $142.35
| Facility | | $40.65 | $63.37 | $142.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.06 / $41.23 / $97.02
| Professional | | $25.06 | $41.23 | $97.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.49 / $57.83 / $81.40
| Professional | | $25.49 | $57.83 | $81.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.40 / $121.61 / $179.15
| Facility | | $36.40 | $121.61 | $179.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.13 / $38.35 / $176.93
| Professional | | $32.13 | $38.35 | $176.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.20 / $64.26 / $85.68
| Professional | | $48.20 | $64.26 | $85.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.56 / $69.20 / $142.35
| Facility | | $41.56 | $69.20 | $142.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.87 / $45.92 / $97.02
| Professional | | $26.87 | $45.92 | $97.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.84 / $42.84 / $42.84
| Facility | | $42.84 | $42.84 | $42.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.84 / $42.84 / $43.70
| Professional | | $42.84 | $42.84 | $43.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.98 / $25.70 / $70.13
| Professional | | $17.98 | $25.70 | $70.13 |