- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.80 / $72.05 / $75.56
| Facility | | $58.80 | $72.05 | $75.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.59 / $61.73 / $72.59
| Professional | | $42.59 | $61.73 | $72.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.91 / $67.36 / $131.19
| Professional | | $64.91 | $67.36 | $131.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.13 / $83.13 / $83.13
| Facility | | $83.13 | $83.13 | $83.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.73 / $57.73 / $86.20
| Professional | | $57.73 | $57.73 | $86.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.12 / $88.75 / $132.83
| Professional | | $64.12 | $88.75 | $132.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.80 / $61.46 / $75.56
| Facility | | $58.80 | $61.46 | $75.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.72 / $63.71 / $76.34
| Professional | | $46.72 | $63.71 | $76.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.14 / $54.14 / $54.14
| Professional | | $54.14 | $54.14 | $54.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.67 / $81.80 / $136.19
| Professional | | $37.67 | $81.80 | $136.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.13 / $83.13 / $83.13
| Facility | | $83.13 | $83.13 | $83.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.73 / $57.73 / $86.20
| Professional | | $57.73 | $57.73 | $86.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.77 / $56.74 / $66.70
| Facility | | $50.77 | $56.74 | $66.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.74 / $66.44 / $69.58
| Professional | | $56.74 | $66.44 | $69.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.17 / $73.70 / $126.67
| Professional | | $58.17 | $73.70 | $126.67 |