- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.27 / $32.27 / $34.85
| Facility | | $32.27 | $32.27 | $34.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.86 / $34.31 / $64.53
| Professional | | $27.86 | $34.31 | $64.53 |
- 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
- $43.88 / $43.88 / $43.88
| Professional | | $43.88 | $43.88 | $43.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.70 / $73.70 / $73.70
| Facility | | $73.70 | $73.70 | $73.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.54 / $34.54 / $34.54
| Facility | | $34.54 | $34.54 | $34.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.21 / $25.21 / $34.54
| Professional | | $25.21 | $25.21 | $34.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.95 / $282.67 / $282.67
| Facility | | $279.95 | $282.67 | $282.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.82 / $364.82 / $480.08
| Professional | | $364.82 | $364.82 | $480.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.80 / $51.37 / $73.70
| Facility | | $17.80 | $51.37 | $73.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.00 / $59.18 / $73.70
| Professional | | $18.00 | $59.18 | $73.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.80 / $49.25 / $73.70
| Facility | | $17.80 | $49.25 | $73.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.21 / $25.21 / $36.82
| Professional | | $25.21 | $25.21 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.98 / $34.00 / $42.20
| Professional | | $22.98 | $34.00 | $42.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.40 / $33.45 / $73.70
| Professional | | $33.40 | $33.45 | $73.70 |