- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.19 / $69.63 / $446.03
| Professional | | $56.19 | $69.63 | $446.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.81 / $75.81 / $75.81
| Facility | | $75.81 | $75.81 | $75.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.35 / $55.35 / $75.81
| Professional | | $55.35 | $55.35 | $75.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.16 / $245.73 / $320.51
| Professional | | $81.16 | $245.73 | $320.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.55 / $95.28 / $118.80
| Facility | | $69.55 | $95.28 | $118.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.21 / $108.98 / $121.74
| Professional | | $86.21 | $108.98 | $121.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.03 / $115.94 / $127.53
| Facility | | $92.03 | $115.94 | $127.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.35 / $115.94 / $124.71
| Professional | | $104.35 | $115.94 | $124.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.55 / $99.58 / $121.74
| Facility | | $69.55 | $99.58 | $121.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.35 / $101.52 / $127.53
| Professional | | $55.35 | $101.52 | $127.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.60 / $192.80 / $406.75
| Facility | | $96.60 | $192.80 | $406.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.71 / $127.53 / $127.53
| Professional | | $99.71 | $127.53 | $127.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.00 / $88.00 / $88.00
| Facility | | $88.00 | $88.00 | $88.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.45 / $57.84 / $110.36
| Professional | | $54.45 | $57.84 | $110.36 |