- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $64.57
| Facility | | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $66.07 / $81.28
| Professional | | $57.54 | $66.07 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $107.15 / $218.78
| Professional | | $72.44 | $107.15 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $323.59 / $524.81
| Facility | | $281.84 | $323.59 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $123.03 / $194.98
| Professional | | $95.50 | $123.03 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $77.62 / $125.89
| Facility | | $61.66 | $77.62 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $186.21 / $281.84
| Professional | | $109.65 | $186.21 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $79.43 / $125.89
| Facility | | $63.10 | $79.43 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $154.88 / $588.84
| Professional | | $87.10 | $154.88 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $478.63
| Facility | | $199.53 | $199.53 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $436.52 / $575.44
| Professional | | $95.50 | $436.52 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $89.13
| Professional | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $154.88 / $213.80
| Professional | | $120.23 | $154.88 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $120.23 / $204.17
| Professional | | $85.11 | $120.23 | $204.17 |