- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $91.20 / $467.74
| Facility | | $67.61 | $91.20 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $74.13 / $158.49
| Professional | | $63.10 | $74.13 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $52.48 / $61.66
| Professional | | $38.02 | $52.48 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $151.36 / $288.40
| Facility | | $61.66 | $151.36 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $74.13
| Professional | | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $44.67
| Facility | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $70.79
| Facility | | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $70.79
| Professional | | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $85.11 / $213.80
| Facility | | $74.13 | $85.11 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $74.13 / $147.91
| Professional | | $63.10 | $74.13 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $87.10 / $229.09
| Facility | | $72.44 | $87.10 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $72.44
| Professional | | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $75.86 / $79.43
| Professional | | $61.66 | $75.86 | $79.43 |