- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $281.84
| Facility | | $199.53 | $199.53 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $128.82 / $371.54
| Professional | | $69.18 | $128.82 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $112.20 / $602.56
| Professional | | $58.88 | $112.20 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $120.23
| Facility | | $45.71 | $45.71 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $162.18 / $245.47
| Professional | | $93.33 | $162.18 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $83.18 / $173.78
| Professional | | $43.65 | $83.18 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $138.04 / $199.53
| Professional | | $107.15 | $138.04 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $154.88 / $251.19
| Professional | | $87.10 | $154.88 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $57.54 / $57.54
| Facility | | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $173.78 / $616.60
| Professional | | $125.89 | $173.78 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $112.20 / $602.56
| Professional | | $61.66 | $112.20 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $52.48 / $120.23
| Facility | | $50.12 | $52.48 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $109.65 / $234.42
| Professional | | $57.54 | $109.65 | $234.42 |