- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.40 / $50.51 / $82.80
| Facility | | $41.40 | $50.51 | $82.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $50.09
| Professional | | $42.48 | $42.48 | $50.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.97 / $33.97 / $42.48
| Facility | | $33.97 | $33.97 | $42.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.73 / $42.48 / $42.48
| Professional | | $41.73 | $42.48 | $42.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $40.07 / $42.48
| Facility | | $40.07 | $40.07 | $42.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $42.48
| Professional | | $42.48 | $42.48 | $42.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $60.11 / $332.00
| Facility | | $40.07 | $60.11 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.08 / $46.08 / $56.57
| Professional | | $46.08 | $46.08 | $56.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $44.08
| Facility | | $42.48 | $42.48 | $44.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $44.08
| Professional | | $42.48 | $42.48 | $44.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $40.07 / $597.00
| Facility | | $40.07 | $40.07 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $59.33
| Professional | | $42.48 | $42.48 | $59.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $59.53
| Professional | | $42.48 | $42.48 | $59.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.08 / $44.08 / $44.08
| Facility | | $44.08 | $44.08 | $44.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.48 / $42.48 / $44.08
| Professional | | $42.48 | $42.48 | $44.08 |