- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $380.19 / $707.95
| Facility | | $354.81 | $380.19 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $371.54 / $436.52
| Professional | | $354.81 | $371.54 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $8.13 / $8.51
| Professional | | $6.76 | $8.13 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Professional | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.88 / $380.19
| Facility | | $8.13 | $12.88 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $371.54 / $371.54
| Professional | | $10.96 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $177.83
| Professional | | $8.91 | $8.91 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.37 / $0.37 / $724.44
| Facility | | $0.37 | $0.37 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $416.87
| Professional | | $371.54 | $371.54 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Facility | | $371.54 | $371.54 | $371.54 |