- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.38 / $38.21 / $162.72
| Facility | | $20.38 | $38.21 | $162.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.37 / $24.27 / $47.34
| Professional | | $20.37 | $24.27 | $47.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.30 / $16.30 / $16.30
| Professional | | $16.30 | $16.30 | $16.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.43 / $69.06 / $100.04
| Facility | | $51.43 | $69.06 | $100.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.81 / $25.81 / $39.93
| Professional | | $25.81 | $25.81 | $39.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.66 / $18.98 / $44.38
| Facility | | $17.66 | $18.98 | $44.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $27.30 / $39.24
| Professional | | $12.10 | $27.30 | $39.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.64 / $24.64 / $129.72
| Facility | | $24.64 | $24.64 | $129.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.41 / $15.53 / $33.96
| Professional | | $11.41 | $15.53 | $33.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.40 / $117.40 / $167.88
| Facility | | $117.40 | $117.40 | $167.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.41 / $13.59 / $17.66
| Professional | | $11.41 | $13.59 | $17.66 |