- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $69.18 / $85.11
| Professional | | $60.26 | $69.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $95.50 / $181.97
| Professional | | $75.86 | $95.50 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $120.23 / $120.23
| Facility | | $120.23 | $120.23 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $69.18
| Professional | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $89.13 / $107.15
| Professional | | $79.43 | $89.13 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $77.62 / $138.04
| Professional | | $69.18 | $77.62 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $489.78
| Facility | | $489.78 | $489.78 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $630.96 / $630.96
| Professional | | $489.78 | $630.96 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $91.20 / $134.90
| Facility | | $66.07 | $91.20 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $194.98
| Professional | | $72.44 | $72.44 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Professional | | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $85.11 / $151.36
| Professional | | $61.66 | $85.11 | $151.36 |