- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.45 / $122.45 / $172.94
| Facility | | $89.45 | $122.45 | $172.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.19 / $122.45 / $267.89
| Professional | | $70.19 | $122.45 | $267.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.06 / $405.70 / $405.70
| Facility | | $77.06 | $405.70 | $405.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.28 / $209.54 / $717.08
| Professional | | $95.28 | $209.54 | $717.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.35 / $171.76 / $269.10
| Professional | | $120.35 | $171.76 | $269.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.81 / $110.81 / $110.81
| Facility | | $110.81 | $110.81 | $110.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.16 / $158.16 / $265.86
| Professional | | $92.16 | $158.16 | $265.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.12 / $83.12 / $105.94
| Facility | | $83.12 | $83.12 | $105.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.72 / $155.18 / $182.56
| Professional | | $145.72 | $155.18 | $182.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.38 / $224.09 / $310.99
| Professional | | $119.38 | $224.09 | $310.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.56 / $193.62 / $361.87
| Professional | | $143.56 | $193.62 | $361.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.70 / $405.70 / $405.70
| Facility | | $405.70 | $405.70 | $405.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.63 / $234.10 / $717.08
| Professional | | $110.63 | $234.10 | $717.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.92 / $67.12 / $101.93
| Facility | | $55.92 | $67.12 | $101.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.22 / $104.86 / $218.42
| Professional | | $69.22 | $104.86 | $218.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.65 / $169.93 / $321.14
| Professional | | $105.65 | $169.93 | $321.14 |