- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.45 / $28.83 / $31.14
| Facility | | $28.45 | $28.83 | $31.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.90 / $30.57 / $41.52
| Professional | | $25.90 | $30.57 | $41.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.17 / $36.17 / $36.17
| Professional | | $36.17 | $36.17 | $36.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.44 / $51.44 / $51.44
| Facility | | $51.44 | $51.44 | $51.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.91 / $17.91 / $17.91
| Professional | | $17.91 | $17.91 | $17.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $205.45 / $208.53
| Facility | | $85.00 | $205.45 | $208.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.25 / $394.00 / $409.76
| Professional | | $329.25 | $394.00 | $409.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.21 / $43.90 / $83.03
| Facility | | $29.21 | $43.90 | $83.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.32 / $41.71 / $43.90
| Professional | | $37.32 | $41.71 | $43.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.02 / $49.26 / $76.83
| Professional | | $43.02 | $49.26 | $76.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.21 / $43.90 / $83.03
| Facility | | $29.21 | $43.90 | $83.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.91 / $17.91 / $36.50
| Professional | | $17.91 | $17.91 | $36.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.52 / $20.62 / $30.18
| Professional | | $15.52 | $20.62 | $30.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.90 / $43.90 / $59.27
| Professional | | $43.90 | $43.90 | $59.27 |