- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.40 / $269.45 / $586.65
| Facility | | $36.40 | $269.45 | $586.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.49 / $38.84 / $118.24
| Professional | | $28.49 | $38.84 | $118.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.92 / $28.92 / $28.92
| Professional | | $28.92 | $28.92 | $28.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.58 / $90.94 / $126.30
| Facility | | $72.58 | $90.94 | $126.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.13 / $42.26 / $113.78
| Professional | | $32.13 | $42.26 | $113.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.56 / $59.73 / $112.09
| Facility | | $32.56 | $59.73 | $112.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.91 / $39.61 / $74.79
| Professional | | $19.91 | $39.61 | $74.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.27 / $60.00 / $93.00
| Facility | | $34.27 | $60.00 | $93.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.65 / $46.65 / $63.39
| Professional | | $46.65 | $46.65 | $63.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.78 / $599.78 / $599.78
| Facility | | $599.78 | $599.78 | $599.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.17 / $60.67 / $71.81
| Facility | | $56.17 | $60.67 | $71.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.42 / $25.70 / $59.15
| Professional | | $21.42 | $25.70 | $59.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.54 / $204.03 / $204.03
| Facility | | $74.54 | $204.03 | $204.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.07 / $416.07 / $416.07
| Professional | | $416.07 | $416.07 | $416.07 |