- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $69.47
| Facility | | $19.50 | $19.50 | $69.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.25 / $19.50 / $37.89
| Professional | | $16.25 | $19.50 | $37.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.83 / $103.75 / $277.54
| Facility | | $34.83 | $103.75 | $277.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.84 / $34.83 / $43.58
| Professional | | $20.84 | $34.83 | $43.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.37 / $57.63 / $74.22
| Facility | | $47.37 | $57.63 | $74.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $38.88 / $38.88
| Professional | | $26.30 | $38.88 | $38.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.83 / $31.30 / $35.00
| Facility | | $25.83 | $31.30 | $35.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.55 / $35.00 / $59.25
| Professional | | $25.55 | $35.00 | $59.25 |
- 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
- $36.13 / $36.13 / $37.94
| Professional | | $36.13 | $36.13 | $37.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.39 / $33.39 / $68.34
| Facility | | $33.39 | $33.39 | $68.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.17 / $34.17 / $34.17
| Professional | | $34.17 | $34.17 | $34.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.75 / $277.54 / $277.54
| Facility | | $103.75 | $277.54 | $277.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.45 / $23.86 / $43.58
| Professional | | $18.45 | $23.86 | $43.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.38 / $23.86 / $43.58
| Professional | | $19.38 | $23.86 | $43.58 |