- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.13 / $29.13 / $29.13
| Facility | | $29.13 | $29.13 | $29.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.14 / $29.66 / $36.78
| Professional | | $27.14 | $29.66 | $36.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.61 / $100.04 / $132.96
| Facility | | $85.61 | $100.04 | $132.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.76 / $45.24 / $61.70
| Professional | | $29.76 | $45.24 | $61.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.70 / $32.20 / $59.67
| Facility | | $27.70 | $32.20 | $59.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.14 / $33.82 / $61.66
| Facility | | $27.14 | $33.82 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.82 / $63.54 / $216.05
| Professional | | $37.82 | $63.54 | $216.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.70 / $50.00 / $70.00
| Professional | | $20.70 | $50.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.70 / $32.20 / $61.66
| Facility | | $27.70 | $32.20 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.36 / $78.88 / $108.18
| Professional | | $50.36 | $78.88 | $108.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $63.68 / $165.80
| Facility | | $40.07 | $63.68 | $165.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.76 / $173.05 / $216.05
| Professional | | $29.76 | $173.05 | $216.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.63 / $40.63 / $40.63
| Professional | | $40.63 | $40.63 | $40.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.84 / $69.05 / $69.05
| Professional | | $56.84 | $69.05 | $69.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.81 / $64.95 / $93.54
| Professional | | $36.81 | $64.95 | $93.54 |