- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.97 / $35.14 / $62.75
| Professional | | $26.97 | $35.14 | $62.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.15 / $123.58 / $258.29
| Facility | | $5.15 | $123.58 | $258.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.00 / $44.15 / $65.92
| Professional | | $35.00 | $44.15 | $65.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.06 / $36.06 / $47.33
| Facility | | $36.06 | $36.06 | $47.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.65 / $36.06 / $47.33
| Professional | | $30.65 | $36.06 | $47.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.26 / $54.26 / $54.26
| Facility | | $54.26 | $54.26 | $54.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.26 / $54.26 / $54.26
| Professional | | $54.26 | $54.26 | $54.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.02 / $62.78 / $69.05
| Professional | | $55.02 | $62.78 | $69.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.93 / $54.26 / $64.53
| Facility | | $53.93 | $54.26 | $64.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.55 / $54.26 / $64.53
| Professional | | $51.55 | $54.26 | $64.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.15 / $49.63 / $49.63
| Facility | | $5.15 | $49.63 | $49.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.48 / $51.10 / $60.58
| Professional | | $4.48 | $51.10 | $60.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.68 / $52.68 / $52.68
| Facility | | $52.68 | $52.68 | $52.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.75 / $25.75 / $46.27
| Professional | | $25.75 | $25.75 | $46.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.15 / $44.15 / $44.15
| Professional | | $44.15 | $44.15 | $44.15 |