- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.05 / $38.25 / $230.57
| Facility | | $31.05 | $38.25 | $230.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.05 / $37.35 / $47.06
| Professional | | $31.05 | $37.35 | $47.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.50 / $37.50 / $37.50
| Professional | | $37.50 | $37.50 | $37.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.86 / $38.86 / $42.76
| Facility | | $38.86 | $38.86 | $42.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.86 / $38.86 / $38.86
| Professional | | $38.86 | $38.86 | $38.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.36 / $38.25
| Facility | | $1.32 | $1.36 | $38.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.25 / $38.25 / $38.25
| Professional | | $38.25 | $38.25 | $38.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.25 / $38.25 / $66.17
| Facility | | $38.25 | $38.25 | $66.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.25 / $38.25 / $43.99
| Professional | | $38.25 | $38.25 | $43.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.25 / $38.86 / $38.86
| Facility | | $38.25 | $38.86 | $38.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.25 / $38.86 / $38.86
| Professional | | $38.25 | $38.86 | $38.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.97 / $7.97 / $40.50
| Facility | | $7.97 | $7.97 | $40.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.36 / $1.36 / $597.00
| Facility | | $1.36 | $1.36 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $9.00 / $38.25
| Professional | | $9.00 | $9.00 | $38.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.50 / $37.50 / $55.30
| Professional | | $37.50 | $37.50 | $55.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.25 / $38.25 / $38.25
| Facility | | $38.25 | $38.25 | $38.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.80 / $38.25 / $38.86
| Professional | | $0.80 | $38.25 | $38.86 |