- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.36 / $43.49 / $57.63
| Facility | | $33.36 | $43.49 | $57.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.01 / $46.81 / $59.51
| Professional | | $38.01 | $46.81 | $59.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.63 / $76.63 / $76.63
| Facility | | $76.63 | $76.63 | $76.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.63 / $76.63 / $76.63
| Professional | | $76.63 | $76.63 | $76.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.56 / $62.56 / $62.56
| Facility | | $62.56 | $62.56 | $62.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.02 / $47.02 / $47.02
| Professional | | $47.02 | $47.02 | $47.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.04 / $132.32 / $332.00
| Facility | | $82.04 | $132.32 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.90 / $71.75 / $107.89
| Professional | | $57.90 | $71.75 | $107.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.72 / $49.72 / $59.17
| Facility | | $49.72 | $49.72 | $59.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.49 / $58.17 / $113.31
| Professional | | $43.49 | $58.17 | $113.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.56 / $62.56 / $62.56
| Facility | | $62.56 | $62.56 | $62.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.02 / $55.70 / $121.60
| Professional | | $47.02 | $55.70 | $121.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.98 / $62.26 / $121.54
| Professional | | $40.98 | $62.26 | $121.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.72 / $57.41 / $59.17
| Facility | | $49.72 | $57.41 | $59.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.07 / $58.17 / $123.80
| Professional | | $47.07 | $58.17 | $123.80 |