- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $389.05 / $562.34
| Facility | | $239.88 | $389.05 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $346.74 / $426.58 / $524.81
| Facility | 25 | $346.74 | $426.58 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $52.48 / $114.82
| Professional | | $30.20 | $52.48 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $467.74 / $524.81
| Facility | | $446.68 | $467.74 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $100.00 / $141.25
| Professional | | $63.10 | $100.00 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $151.36 / $354.81
| Facility | | $102.33 | $151.36 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $107.15 / $169.82
| Professional | | $54.95 | $107.15 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $165.96 / $281.84
| Facility | | $114.82 | $165.96 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $102.33 / $151.36
| Professional | | $69.18 | $102.33 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $64.57 / $257.04
| Facility | | $37.15 | $64.57 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $144.54 / $323.59 / $354.81
| Facility | 25 | $144.54 | $323.59 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $95.50 / $501.19
| Professional | | $44.67 | $95.50 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $81.28 / $138.04
| Professional | | $42.66 | $81.28 | $138.04 |