- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.98 / $95.63 / $126.74
| Facility | | $72.98 | $95.63 | $126.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.29 / $103.06 / $131.21
| Professional | | $83.29 | $103.06 | $131.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.14 / $170.14 / $170.14
| Facility | | $170.14 | $170.14 | $170.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.14 / $170.14 / $170.14
| Professional | | $170.14 | $170.14 | $170.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.66 / $138.66 / $138.66
| Facility | | $138.66 | $138.66 | $138.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.45 / $104.45 / $104.45
| Professional | | $104.45 | $104.45 | $104.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.47 / $293.00 / $332.00
| Facility | | $182.47 | $293.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.78 / $158.87 / $239.98
| Professional | | $128.78 | $158.87 | $239.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.59 / $110.59 / $131.60
| Facility | | $110.59 | $110.59 | $131.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.53 / $129.38 / $251.47
| Professional | | $96.53 | $129.38 | $251.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.66 / $138.66 / $138.66
| Facility | | $138.66 | $138.66 | $138.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.45 / $124.09 / $267.08
| Professional | | $104.45 | $124.09 | $267.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.53 / $138.24 / $270.77
| Professional | | $89.53 | $138.24 | $270.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.59 / $127.42 / $131.60
| Facility | | $110.59 | $127.42 | $131.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.48 / $127.42 / $272.23
| Professional | | $104.48 | $127.42 | $272.23 |