- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $229.09 / $407.38
| Facility | | $91.20 | $229.09 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $77.62 / $323.59
| Professional | | $57.54 | $77.62 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $104.71 / $114.82
| Facility | | $50.12 | $104.71 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $102.33 / $263.03
| Professional | | $74.13 | $102.33 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $204.17 / $251.19
| Professional | | $109.65 | $204.17 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $107.15 / $239.88
| Facility | | $81.28 | $107.15 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $162.18 / $239.88
| Professional | | $107.15 | $162.18 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $181.97 / $199.53
| Facility | | $131.83 | $181.97 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $97.72 / $190.55
| Facility | | $70.79 | $97.72 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $131.83 / $251.19
| Professional | | $79.43 | $131.83 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $223.87 / $407.38
| Facility | | $147.91 | $223.87 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $123.03 / $263.03
| Professional | | $102.33 | $123.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $107.15 / $154.88
| Facility | | $107.15 | $107.15 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $87.10 / $204.17
| Professional | | $79.43 | $87.10 | $204.17 |