- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.79 / $51.80 / $76.17
| Facility | | $43.79 | $51.80 | $76.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.79 / $50.78 / $53.95
| Professional | | $43.79 | $50.78 | $53.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $52.89 / $83.34
| Professional | | $47.86 | $52.89 | $83.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.89 / $52.89 / $58.18
| Facility | | $52.89 | $52.89 | $58.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.89 / $52.89 / $52.89
| Professional | | $52.89 | $52.89 | $52.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.30 / $50.77 / $53.95
| Facility | | $49.30 | $50.77 | $53.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.95 / $53.95 / $53.95
| Professional | | $53.95 | $53.95 | $53.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.15 / $63.21 / $332.00
| Facility | | $45.15 | $63.21 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.15 / $81.27 / $125.52
| Professional | | $45.15 | $81.27 | $125.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.76 / $28.76 / $28.76
| Professional | | $28.76 | $28.76 | $28.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.77 / $50.77 / $597.00
| Facility | | $50.77 | $50.77 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.95 / $53.95 / $80.61
| Professional | | $53.95 | $53.95 | $80.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.89 / $52.89 / $74.12
| Professional | | $52.89 | $52.89 | $74.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.40 / $38.40 / $43.54
| Facility | | $38.40 | $38.40 | $43.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.76 / $38.40 / $44.03
| Professional | | $28.76 | $38.40 | $44.03 |