- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.71 / $29.31 / $38.93
| Facility | | $21.71 | $29.31 | $38.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.60 / $31.03 / $39.46
| Professional | | $25.60 | $31.03 | $39.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.25 / $52.25 / $52.25
| Facility | | $52.25 | $52.25 | $52.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.25 / $52.25 / $52.25
| Professional | | $52.25 | $52.25 | $52.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.40 / $42.40 / $42.40
| Facility | | $42.40 | $42.40 | $42.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.84 / $31.84 / $31.84
| Professional | | $31.84 | $31.84 | $31.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.67 / $89.10 / $332.00
| Facility | | $55.67 | $89.10 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.29 / $48.31 / $73.22
| Professional | | $39.29 | $48.31 | $73.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.74 / $33.74 / $40.15
| Facility | | $33.74 | $33.74 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.52 / $39.47 / $76.90
| Professional | | $29.52 | $39.47 | $76.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.40 / $42.40 / $42.40
| Facility | | $42.40 | $42.40 | $42.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.84 / $37.83 / $79.91
| Professional | | $31.84 | $37.83 | $79.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.58 / $40.65 / $82.55
| Professional | | $26.58 | $40.65 | $82.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.74 / $38.96 / $40.15
| Facility | | $33.74 | $38.96 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.95 / $39.47 / $83.61
| Professional | | $31.95 | $39.47 | $83.61 |