- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.65 / $33.65 / $33.65
| Facility | | $33.65 | $33.65 | $33.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.65 / $33.86 / $49.32
| Professional | | $33.65 | $33.86 | $49.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.79 / $165.51 / $365.94
| Facility | | $46.79 | $165.51 | $365.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.55 / $53.36 / $75.25
| Professional | | $30.55 | $53.36 | $75.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.56 / $44.56 / $132.34
| Facility | | $44.56 | $44.56 | $132.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.45 / $52.91 / $52.91
| Professional | | $50.45 | $52.91 | $52.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $44.56 / $54.02
| Facility | | $36.72 | $44.56 | $54.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $36.72 / $94.50
| Professional | | $26.81 | $36.72 | $94.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.39 / $62.39 / $65.51
| Professional | | $62.39 | $62.39 | $65.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.82 / $42.82 / $42.82
| Facility | | $42.82 | $42.82 | $42.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.82 / $42.82 / $42.82
| Professional | | $42.82 | $42.82 | $42.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.51 / $365.94 / $365.94
| Facility | | $165.51 | $365.94 | $365.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.04 / $38.44 / $75.25
| Professional | | $28.04 | $38.44 | $75.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.52 / $39.52 / $73.77
| Professional | | $28.52 | $39.52 | $73.77 |