- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.78 / $28.78 / $31.08
| Facility | | $28.78 | $28.78 | $31.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.78 / $31.63 / $57.55
| Professional | | $28.78 | $31.63 | $57.55 |
- 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
- $39.13 / $39.13 / $39.13
| Professional | | $39.13 | $39.13 | $39.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.73 / $65.73 / $65.73
| Facility | | $65.73 | $65.73 | $65.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.25 / $37.25 / $37.25
| Facility | | $37.25 | $37.25 | $37.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.19 / $27.19 / $37.25
| Professional | | $27.19 | $27.19 | $37.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.20 / $304.39 / $304.39
| Facility | | $124.20 | $304.39 | $304.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.36 / $332.69 / $439.05
| Professional | | $325.36 | $332.69 | $439.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.86 / $45.81 / $65.73
| Facility | | $18.86 | $45.81 | $65.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.07 / $58.54 / $65.73
| Professional | | $19.07 | $58.54 | $65.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.86 / $43.92 / $65.73
| Facility | | $18.86 | $43.92 | $65.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.19 / $27.19 / $39.71
| Professional | | $27.19 | $27.19 | $39.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.34 / $36.01 / $44.59
| Professional | | $24.34 | $36.01 | $44.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.43 / $35.46 / $65.73
| Professional | | $35.43 | $35.46 | $65.73 |