- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.40 / $89.35 / $186.15
| Facility | | $51.40 | $89.35 | $186.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.64 / $53.53 / $69.08
| Professional | | $47.64 | $53.53 | $69.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.71 / $80.26 / $158.55
| Facility | | $31.71 | $80.26 | $158.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.04 / $37.04 / $37.04
| Professional | | $37.04 | $37.04 | $37.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.66 / $32.78 / $145.47
| Facility | | $21.66 | $32.78 | $145.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.66 / $21.66 / $21.66
| Professional | | $21.66 | $21.66 | $21.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.60 / $35.60 / $35.60
| Facility | | $35.60 | $35.60 | $35.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.10 / $50.10 / $50.10
| Facility | | $50.10 | $50.10 | $50.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.10 / $50.10 / $50.10
| Professional | | $50.10 | $50.10 | $50.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $107.06 / $191.33
| Facility | | $85.00 | $107.06 | $191.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.97 / $53.53 / $76.55
| Facility | | $25.97 | $53.53 | $76.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.31 / $22.31 / $96.00
| Professional | | $22.31 | $22.31 | $96.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.40 / $50.10 / $76.55
| Facility | | $28.40 | $50.10 | $76.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.54 / $50.10 / $50.10
| Professional | | $31.54 | $50.10 | $50.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.49 / $52.78 / $53.53
| Professional | | $42.49 | $52.78 | $53.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.49 / $43.49 / $58.71
| Professional | | $43.49 | $43.49 | $58.71 |