- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $81.28 / $95.50
| Facility | | $72.44 | $81.28 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $64.57 / $95.50
| Professional | | $50.12 | $64.57 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $81.28 / $204.17
| Professional | | $7.59 | $81.28 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $112.20 / $186.21
| Facility | | $85.11 | $112.20 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $85.11 / $186.21
| Professional | | $64.57 | $85.11 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $69.18 / $162.18
| Professional | | $50.12 | $69.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $83.18
| Facility | | $63.10 | $63.10 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $81.28 / $151.36
| Professional | | $45.71 | $81.28 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $97.72 / $181.97
| Professional | | $57.54 | $97.72 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $61.66 / $61.66
| Professional | | $54.95 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $81.28 / $204.17
| Professional | | $7.59 | $81.28 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $75.86 / $169.82
| Professional | | $6.76 | $75.86 | $169.82 |