- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.04 / $31.35 / $33.31
| Facility | | $27.04 | $31.35 | $33.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.04 / $32.53 / $33.31
| Professional | | $27.04 | $32.53 | $33.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.65 / $32.65 / $33.22
| Professional | | $32.65 | $32.65 | $33.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.86 / $161.86 / $161.86
| Facility | | $161.86 | $161.86 | $161.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.86 / $161.86 / $161.86
| Professional | | $161.86 | $161.86 | $161.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.31 / $164.93 / $164.93
| Facility | | $33.31 | $164.93 | $164.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.31 / $33.31 / $33.31
| Professional | | $33.31 | $33.31 | $33.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.18 / $100.95 / $332.00
| Facility | | $61.18 | $100.95 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.74 / $69.09 / $69.09
| Professional | | $58.74 | $69.09 | $69.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.09 / $71.80 / $71.80
| Facility | | $69.09 | $71.80 | $71.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.09 / $71.80 / $71.80
| Professional | | $69.09 | $71.80 | $71.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.31 / $164.93 / $597.00
| Facility | | $33.31 | $164.93 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.31 / $33.31 / $65.00
| Professional | | $33.31 | $33.31 | $65.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.65 / $32.65 / $44.09
| Professional | | $32.65 | $32.65 | $44.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.60 / $69.09 / $69.09
| Facility | | $30.60 | $69.09 | $69.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.60 / $69.09 / $71.80
| Professional | | $30.60 | $69.09 | $71.80 |