- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.80 / $103.33 / $137.65
| Facility | | $92.80 | $103.33 | $137.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.72 / $103.33 / $137.65
| Professional | | $79.72 | $103.33 | $137.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.66 / $274.92 / $563.32
| Facility | | $149.66 | $274.92 | $563.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.69 / $11.22 / $11.22
| Professional | | $9.69 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.41 / $163.41 / $163.41
| Facility | | $163.41 | $163.41 | $163.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.30 / $120.30 / $145.07
| Facility | | $120.30 | $120.30 | $145.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.26 / $120.30 / $148.61
| Professional | | $102.26 | $120.30 | $148.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.49 / $812.03 / $812.03
| Facility | | $269.49 | $812.03 | $812.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.40 / $137.65 / $173.48
| Facility | | $77.40 | $137.65 | $173.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.03 / $138.90 / $203.94
| Professional | | $15.03 | $138.90 | $203.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.40 / $120.30 / $168.08
| Facility | | $77.40 | $120.30 | $168.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.26 / $120.30 / $148.61
| Professional | | $102.26 | $120.30 | $148.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.81 / $102.65 / $169.45
| Professional | | $70.81 | $102.65 | $169.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.00 / $127.78 / $127.78
| Professional | | $123.00 | $127.78 | $127.78 |