- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.04 / $33.79 / $38.36
| Facility | | $26.04 | $33.79 | $38.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.04 / $34.26 / $45.68
| Professional | | $26.04 | $34.26 | $45.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.44 / $29.79 / $33.32
| Facility | | $27.44 | $29.79 | $33.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.86 / $27.86 / $27.86
| Professional | | $27.86 | $27.86 | $27.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.16 / $52.16 / $52.16
| Facility | | $52.16 | $52.16 | $52.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.45 / $34.45 / $35.47
| Facility | | $34.45 | $34.45 | $35.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.28 / $29.28 / $34.45
| Professional | | $21.28 | $29.28 | $34.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.00 / $247.76 / $247.76
| Facility | | $245.00 | $247.76 | $247.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.76 / $259.76 / $391.20
| Professional | | $259.76 | $259.76 | $391.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.28 / $38.36 / $52.16
| Facility | | $14.28 | $38.36 | $52.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.92 / $46.94 / $52.16
| Professional | | $31.92 | $46.94 | $52.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.28 / $37.33 / $52.16
| Facility | | $14.28 | $37.33 | $52.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.28 / $29.28 / $36.86
| Professional | | $21.28 | $29.28 | $36.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.43 / $24.06 / $31.73
| Professional | | $18.43 | $24.06 | $31.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.13 / $26.13 / $52.16
| Professional | | $26.13 | $26.13 | $52.16 |