- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $67.61 / $102.33
| Facility | | $60.26 | $67.61 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $72.44 / $91.20
| Professional | | $58.88 | $72.44 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $85.11 / $107.15
| Professional | | $72.44 | $85.11 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $75.86 / $85.11
| Professional | | $60.26 | $75.86 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $70.79 / $85.11
| Facility | | $64.57 | $70.79 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $89.13 / $141.25
| Professional | | $69.18 | $89.13 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $467.74
| Facility | | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Professional | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $75.86 / $107.15
| Facility | | $60.26 | $75.86 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $72.44 / $104.71
| Professional | | $58.88 | $72.44 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $72.44 / $97.72
| Facility | | $58.88 | $72.44 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $89.13 / $138.04
| Professional | | $69.18 | $89.13 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $87.10 / $125.89
| Professional | | $64.57 | $87.10 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $85.11 / $107.15
| Professional | | $61.66 | $85.11 | $107.15 |