- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $380.19 / $512.86
| Facility | | $38.90 | $380.19 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $30.20 / $42.66
| Professional | | $28.18 | $30.20 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $4.57 / $5,011.87
| Facility | | $3.89 | $4.57 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $4.57 / $4.57
| Professional | | $4.57 | $4.57 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $30.90
| Facility | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $25.70 / $25.70
| Professional | | $21.88 | $25.70 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $131.83 / $323.59
| Facility | | $58.88 | $131.83 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $323.59 / $512.86
| Facility | | $47.86 | $323.59 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $30.20 / $72.44
| Professional | | $28.18 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $575.44 / $691.83
| Professional | | $0.60 | $575.44 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $38.02 / $51.29
| Facility | | $33.88 | $38.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $38.02 / $309.03
| Professional | | $20.42 | $38.02 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $37.15
| Professional | | $30.20 | $30.20 | $37.15 |