- 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
- $52.48 / $64.57 / $85.11
| Professional | | $52.48 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $95.50 / $218.78
| Professional | | $60.26 | $95.50 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $173.78 / $281.84
| Facility | | $134.90 | $173.78 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $125.89 / $181.97
| Professional | | $63.10 | $125.89 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $67.61 / $93.33
| Facility | | $52.48 | $67.61 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $70.79 / $112.20
| Facility | | $54.95 | $70.79 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $104.71 / $512.86
| Professional | | $60.26 | $104.71 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $162.18 / $229.09
| Professional | | $102.33 | $162.18 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $154.88 / $426.58
| Facility | | $134.90 | $154.88 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $234.42 / $512.86
| Professional | | $61.66 | $234.42 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $173.78
| Professional | | $169.82 | $169.82 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $85.11 / $177.83
| Professional | | $56.23 | $85.11 | $177.83 |