- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.64 / $143.32 / $343.20
| Facility | | $66.64 | $143.32 | $343.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.64 / $67.34 / $166.11
| Professional | | $66.64 | $67.34 | $166.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.70 / $106.44 / $238.61
| Facility | | $70.70 | $106.44 | $238.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.64 / $71.66 / $157.53
| Professional | | $66.64 | $71.66 | $157.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.50 / $90.77 / $110.91
| Facility | | $71.50 | $90.77 | $110.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.90 / $67.90 / $169.78
| Professional | | $67.90 | $67.90 | $169.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.87 / $62.87 / $66.64
| Facility | | $62.87 | $62.87 | $66.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.64 / $66.64 / $66.64
| Professional | | $66.64 | $66.64 | $66.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.98 / $79.97 / $151.02
| Professional | | $59.98 | $79.97 | $151.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.77 / $325.75 / $333.20
| Facility | | $90.77 | $325.75 | $333.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.87 / $66.64 / $95.30
| Facility | | $62.87 | $66.64 | $95.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.64 / $66.64 / $144.13
| Professional | | $66.64 | $66.64 | $144.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.85 / $112.85 / $112.85
| Professional | | $112.85 | $112.85 | $112.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.31 / $73.31 / $113.29
| Professional | | $53.31 | $73.31 | $113.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.64 / $66.64 / $137.35
| Professional | | $66.64 | $66.64 | $137.35 |