- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $47.86 / $144.54
| Facility | | $20.42 | $47.86 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $23.99 / $33.88
| Professional | | $18.20 | $23.99 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $31.62
| Professional | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $31.62
| Facility | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $24.55 / $141.25
| Facility | | $20.42 | $24.55 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $38.02 / $47.86
| Professional | | $32.36 | $38.02 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $31.62 / $58.88
| Facility | | $19.50 | $31.62 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $25.70 / $36.31
| Professional | | $19.05 | $25.70 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $23.44 / $23.44
| Professional | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $31.62 / $79.43
| Facility | | $16.60 | $31.62 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $31.62 / $79.43
| Professional | | $24.55 | $31.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $14.79 / $31.62
| Facility | | $11.48 | $14.79 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $13.18 / $31.62
| Professional | | $13.18 | $13.18 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $3.80
| Professional | | $3.80 | $3.80 | $3.80 |