- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.62 / $84.97 / $104.57
| Facility | | $73.62 | $84.97 | $104.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.78 / $69.06 / $84.97
| Professional | | $59.78 | $69.06 | $84.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.38 / $144.87 / $390.29
| Facility | | $102.38 | $144.87 | $390.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.42 / $193.97 / $641.63
| Professional | | $103.42 | $193.97 | $641.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.93 / $94.93 / $94.93
| Professional | | $94.93 | $94.93 | $94.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.12 / $91.67 / $176.22
| Facility | | $64.12 | $91.67 | $176.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.12 / $89.88 / $159.84
| Professional | | $64.12 | $89.88 | $159.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.91 / $148.58 / $262.20
| Professional | | $27.91 | $148.58 | $262.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.87 / $174.35 / $212.39
| Facility | | $121.87 | $174.35 | $212.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.38 / $102.38 / $144.87
| Facility | | $102.38 | $102.38 | $144.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.42 / $167.24 / $245.36
| Professional | | $104.42 | $167.24 | $245.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.41 / $143.43 / $227.29
| Professional | | $104.41 | $143.43 | $227.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.83 / $124.84 / $215.64
| Professional | | $94.83 | $124.84 | $215.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.07 / $88.07 / $104.57
| Professional | | $88.07 | $88.07 | $104.57 |