- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.38 / $116.55 / $7,329.43
| Facility | | $48.38 | $116.55 | $7,329.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $48.48 / $108.02
| Professional | | $47.53 | $48.48 | $108.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.52 / $80.80 / $170.69
| Facility | | $47.52 | $80.80 | $170.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $47.53 / $59.41
| Professional | | $47.53 | $47.53 | $59.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.83 / $47.52 / $47.52
| Facility | | $44.83 | $47.52 | $47.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.52 / $47.52 / $47.52
| Professional | | $47.52 | $47.52 | $47.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.38 / $66.56 / $240.30
| Facility | | $48.38 | $66.56 | $240.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.78 / $48.38 / $55.98
| Professional | | $43.78 | $48.38 | $55.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.53 / $47.53 / $47.53
| Facility | | $47.53 | $47.53 | $47.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $47.53 / $56.48
| Professional | | $47.53 | $47.53 | $56.48 |