- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.21 / $48.14 / $49.06
| Facility | | $47.21 | $48.14 | $49.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.36 / $49.06 / $83.66
| Professional | | $45.36 | $49.06 | $83.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.31 / $50.31 / $62.95
| Professional | | $50.31 | $50.31 | $62.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.72 / $105.72 / $105.72
| Facility | | $105.72 | $105.72 | $105.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.81 / $61.81 / $61.81
| Facility | | $61.81 | $61.81 | $61.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.12 / $45.12 / $61.81
| Professional | | $45.12 | $45.12 | $61.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.41 / $510.12 / $605.05
| Facility | | $214.41 | $510.12 | $605.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.70 / $693.95 / $944.55
| Professional | | $677.70 | $693.95 | $944.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.77 / $73.14 / $105.72
| Facility | | $30.77 | $73.14 | $105.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.77 / $95.15 / $127.38
| Professional | | $30.77 | $95.15 | $127.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.77 / $70.64 / $105.72
| Facility | | $30.77 | $70.64 | $105.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.12 / $45.12 / $65.89
| Professional | | $45.12 | $45.12 | $65.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.72 / $58.76 / $68.38
| Professional | | $39.72 | $58.76 | $68.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.20 / $57.23 / $105.72
| Professional | | $57.20 | $57.23 | $105.72 |