- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $74.13 / $6,165.95
| Facility | | $34.67 | $74.13 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $53.70
| Professional | | $44.67 | $44.67 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $91.20 / $154.88
| Facility | | $45.71 | $91.20 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $75.86
| Professional | | $45.71 | $45.71 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $63.10 / $95.50
| Professional | | $54.95 | $63.10 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $45.71 / $45.71
| Facility | | $42.66 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $45.71
| Professional | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $45.71 / $61.66
| Professional | | $38.90 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $50.12 / $66.07
| Facility | | $18.20 | $50.12 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $50.12 / $67.61
| Facility | | $43.65 | $50.12 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $50.12 / $67.61
| Professional | | $43.65 | $50.12 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $45.71 / $66.07
| Facility | | $39.81 | $45.71 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $45.71 / $57.54
| Professional | | $43.65 | $45.71 | $57.54 |