- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.18 / $59.28 / $75.84
| Facility | | $34.18 | $59.28 | $75.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.18 / $34.52 / $47.82
| Professional | | $34.18 | $34.52 | $47.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.25 / $56.31 / $111.25
| Facility | | $22.25 | $56.31 | $111.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.22 / $32.22 / $49.00
| Professional | | $32.22 | $32.22 | $49.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.25 / $34.18 / $34.18
| Facility | | $32.25 | $34.18 | $34.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.18 / $34.18 / $34.18
| Professional | | $34.18 | $34.18 | $34.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $167.48 / $170.90
| Facility | | $75.00 | $167.48 | $170.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.49 / $34.18 / $50.35
| Facility | | $8.49 | $34.18 | $50.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.63 / $34.18 / $62.15
| Professional | | $25.63 | $34.18 | $62.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.65 / $34.18 / $49.36
| Facility | | $15.65 | $34.18 | $49.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.40 / $34.18 / $59.95
| Professional | | $32.40 | $34.18 | $59.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.07 / $33.07 / $33.07
| Facility | | $33.07 | $33.07 | $33.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.18 / $34.18 / $34.18
| Professional | | $34.18 | $34.18 | $34.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $33.11 / $46.14
| Professional | | $33.11 | $33.11 | $46.14 |