- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.28 / $51.94 / $199.71
| Facility | | $43.28 | $51.94 | $199.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.95 / $45.92 / $61.10
| Professional | | $41.95 | $45.92 | $61.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.72 / $157.22 / $288.25
| Facility | | $66.72 | $157.22 | $288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.24 / $49.71 / $54.37
| Professional | | $36.24 | $49.71 | $54.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.24 / $61.17 / $93.71
| Professional | | $45.24 | $61.17 | $93.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.69 / $261.35 / $876.56
| Facility | | $240.69 | $261.35 | $876.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,028.34 / $1,028.34 / $1,028.34
| Professional | | $1,028.34 | $1,028.34 | $1,028.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.28 / $51.64 / $73.89
| Facility | | $43.28 | $51.64 | $73.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.06 / $66.86 / $92.57
| Professional | | $48.06 | $66.86 | $92.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.28 / $51.50 / $71.92
| Facility | | $43.28 | $51.50 | $71.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.28 / $62.34 / $94.98
| Professional | | $46.28 | $62.34 | $94.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.58 / $57.90 / $82.96
| Professional | | $43.58 | $57.90 | $82.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.89 / $50.54 / $69.77
| Professional | | $43.89 | $50.54 | $69.77 |