- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $41.69 / $125.89
| Facility | | $18.20 | $41.69 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $14.13 / $95.50
| Professional | | $8.91 | $14.13 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $38.02 / $52.48
| Facility | | $23.44 | $38.02 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $14.45 / $25.70
| Professional | | $9.55 | $14.45 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $31.62 / $38.02
| Professional | | $14.45 | $31.62 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $48.98
| Facility | | $14.45 | $14.45 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $18.20 / $29.51
| Professional | | $14.45 | $18.20 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $32.36
| Facility | | $14.45 | $14.45 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $20.89 / $48.98
| Facility | | $14.13 | $20.89 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $18.20 / $79.43
| Professional | | $14.45 | $18.20 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $43.65 / $60.26
| Facility | | $21.88 | $43.65 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.45 / $18.62
| Professional | | $10.96 | $14.45 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $23.44
| Facility | | $17.38 | $17.38 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $8.32 / $20.42
| Professional | | $6.17 | $8.32 | $20.42 |