- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.73 / $60.79 / $112.46
| Facility | | $56.73 | $60.79 | $112.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.60 / $58.12 / $76.19
| Professional | | $45.60 | $58.12 | $76.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.55 / $68.02 / $126.23
| Professional | | $65.55 | $68.02 | $126.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.37 / $84.37 / $84.37
| Facility | | $84.37 | $84.37 | $84.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.91 / $79.95 / $134.57
| Professional | | $54.91 | $79.95 | $134.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.81 / $89.64 / $134.15
| Professional | | $64.81 | $89.64 | $134.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.78 / $50.78 / $53.71
| Professional | | $50.78 | $50.78 | $53.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.43 / $60.79 / $128.51
| Facility | | $55.43 | $60.79 | $128.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.50 / $61.17 / $97.15
| Professional | | $47.50 | $61.17 | $97.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $63.76 / $81.81
| Professional | | $50.00 | $63.76 | $81.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $60.50 / $79.52
| Professional | | $50.00 | $60.50 | $79.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.37 / $84.37 / $84.37
| Facility | | $84.37 | $84.37 | $84.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.91 / $80.15 / $146.36
| Professional | | $54.91 | $80.15 | $146.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.17 / $66.17 / $66.17
| Facility | | $66.17 | $66.17 | $66.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.17 / $66.17 / $66.17
| Professional | | $66.17 | $66.17 | $66.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.57 / $70.00 / $109.58
| Professional | | $52.57 | $70.00 | $109.58 |