- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.71 / $252.00 / $341.69
| Facility | | $87.71 | $252.00 | $341.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.99 / $58.83 / $83.54
| Professional | | $29.99 | $58.83 | $83.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.42 / $89.12 / $167.10
| Facility | | $33.42 | $89.12 | $167.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.31 / $31.99 / $78.73
| Professional | | $26.31 | $31.99 | $78.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.26 / $79.73 / $119.46
| Facility | | $64.26 | $79.73 | $119.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.84 / $43.70 / $53.55
| Professional | | $42.84 | $43.70 | $53.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.78 / $38.56 / $83.54
| Professional | | $32.78 | $38.56 | $83.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.26 / $96.39 / $157.65
| Facility | | $64.26 | $96.39 | $157.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $75.53 / $84.16
| Professional | | $73.33 | $75.53 | $84.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.98 / $25.48 / $70.51
| Professional | | $17.98 | $25.48 | $70.51 |