- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.84 / $70.84 / $70.84
| Facility | | $70.84 | $70.84 | $70.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.07 / $71.38 / $87.55
| Professional | | $63.07 | $71.38 | $87.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.34 / $105.48 / $218.60
| Professional | | $71.34 | $105.48 | $218.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.68 / $354.87 / $544.38
| Facility | | $303.68 | $354.87 | $544.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $132.87 / $210.08
| Professional | | $102.67 | $132.87 | $210.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.98 / $85.31 / $137.61
| Facility | | $68.98 | $85.31 | $137.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.89 / $87.19 / $141.69
| Facility | | $68.89 | $87.19 | $141.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.33 / $153.86 / $639.32
| Professional | | $91.33 | $153.86 | $639.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.91 / $111.62 / $265.86
| Professional | | $77.91 | $111.62 | $265.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.98 / $85.31 / $137.61
| Facility | | $68.98 | $85.31 | $137.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.82 / $155.82 / $424.81
| Facility | | $155.82 | $155.82 | $424.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $483.84 / $639.32
| Professional | | $102.67 | $483.84 | $639.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.01 / $98.01 / $98.01
| Professional | | $98.01 | $98.01 | $98.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.98 / $168.98 / $235.32
| Professional | | $168.98 | $168.98 | $235.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.78 / $138.40 / $215.26
| Professional | | $87.78 | $138.40 | $215.26 |