- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $125.89 / $338.84
| Professional | | $64.57 | $125.89 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $83.18 / $204.17 / $363.08
| Professional | 25 | $83.18 | $204.17 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $85.11 / $478.63
| Facility | | $56.23 | $85.11 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $141.25 / $354.81
| Professional | | $69.18 | $141.25 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $151.36 / $269.15
| Professional | | $87.10 | $151.36 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $131.83 / $309.03
| Professional | | $61.66 | $131.83 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $112.20 / $213.80
| Professional | | $66.07 | $112.20 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $154.88 / $331.13
| Professional | | $69.18 | $154.88 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $309.03
| Professional | | $79.43 | $79.43 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $85.11 / $478.63
| Facility | | $56.23 | $85.11 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $138.04 / $354.81
| Professional | | $69.18 | $138.04 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $56.23 / $56.23
| Facility | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $102.33 / $239.88
| Professional | | $57.54 | $102.33 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $112.20 / $263.03
| Professional | | $53.70 | $112.20 | $263.03 |