- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.15 / $71.53 / $107.46
| Facility | | $71.15 | $71.53 | $107.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.25 / $71.53 / $144.97
| Professional | | $56.25 | $71.53 | $144.97 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $209.30 / $209.30 / $209.30
| Professional | 25 | $209.30 | $209.30 | $209.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.62 / $348.46 / $348.46
| Facility | | $52.62 | $348.46 | $348.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.76 / $135.68 / $450.62
| Professional | | $65.76 | $135.68 | $450.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.26 / $81.26 / $103.12
| Facility | | $81.26 | $81.26 | $103.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.58 / $133.26 / $176.80
| Professional | | $92.58 | $133.26 | $176.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.80 / $94.80 / $94.80
| Facility | | $94.80 | $94.80 | $94.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.06 / $129.53 / $205.62
| Professional | | $71.06 | $129.53 | $205.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.31 / $71.31 / $90.88
| Facility | | $71.31 | $71.31 | $90.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.31 / $71.66 / $117.42
| Professional | | $40.31 | $71.66 | $117.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.24 / $171.80 / $216.28
| Professional | | $87.24 | $171.80 | $216.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.29 / $136.16 / $216.57
| Professional | | $108.29 | $136.16 | $216.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.46 / $348.46 / $348.46
| Facility | | $348.46 | $348.46 | $348.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.22 / $130.41 / $454.95
| Professional | | $79.22 | $130.41 | $454.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.86 / $106.30 / $193.24
| Professional | | $77.86 | $106.30 | $193.24 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $94.07 / $94.07 / $94.07
| Professional | 25 | $94.07 | $94.07 | $94.07 |