- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.14 / $34.14 / $36.86
| Facility | | $34.14 | $34.14 | $36.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.14 / $37.43 / $68.28
| Professional | | $34.14 | $37.43 | $68.28 |
- 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
- $46.43 / $46.43 / $46.43
| Professional | | $46.43 | $46.43 | $46.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.98 / $77.98 / $77.98
| Facility | | $77.98 | $77.98 | $77.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.73 / $48.73 / $48.73
| Facility | | $48.73 | $48.73 | $48.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.57 / $35.57 / $48.73
| Professional | | $35.57 | $35.57 | $48.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.12 / $415.88 / $415.88
| Facility | | $406.12 | $415.88 | $415.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.77 / $517.77 / $584.85
| Professional | | $517.77 | $517.77 | $584.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.11 / $54.34 / $77.98
| Facility | | $25.11 | $54.34 | $77.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.40 / $71.73 / $77.98
| Professional | | $25.40 | $71.73 | $77.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.11 / $52.10 / $77.98
| Facility | | $25.11 | $52.10 | $77.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.57 / $35.57 / $51.94
| Professional | | $35.57 | $35.57 | $51.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.97 / $39.97 / $39.97
| Facility | | $39.97 | $39.97 | $39.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.42 / $47.96 / $58.62
| Professional | | $32.42 | $47.96 | $58.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.19 / $53.69 / $77.98
| Professional | | $47.19 | $53.69 | $77.98 |