- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.52 / $28.06 / $28.60
| Facility | | $27.52 | $28.06 | $28.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.90 / $28.60 / $46.41
| Professional | | $25.90 | $28.60 | $46.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.33 / $33.02 / $36.69
| Professional | | $29.33 | $33.02 | $36.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.61 / $61.61 / $61.61
| Facility | | $61.61 | $61.61 | $61.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $36.72 / $36.72
| Facility | | $36.72 | $36.72 | $36.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $26.81 / $36.72
| Professional | | $26.81 | $26.81 | $36.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.97 / $285.48 / $285.48
| Facility | | $102.97 | $285.48 | $285.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.61 / $308.61 / $448.80
| Professional | | $308.61 | $308.61 | $448.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.64 / $41.18 / $61.61
| Facility | | $17.64 | $41.18 | $61.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.64 / $55.45 / $61.61
| Professional | | $17.64 | $55.45 | $61.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.13 / $62.84 / $138.62
| Professional | | $47.13 | $62.84 | $138.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.64 / $38.21 / $61.61
| Facility | | $17.64 | $38.21 | $61.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $26.81 / $39.15
| Professional | | $26.81 | $26.81 | $39.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.77 / $32.90 / $39.20
| Professional | | $22.77 | $32.90 | $39.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.81 / $61.61
| Professional | | $32.36 | $32.81 | $61.61 |