- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.35 / $61.59 / $94.71
| Facility | | $18.35 | $61.59 | $94.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $20.28 / $40.74
| Professional | | $17.67 | $20.28 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.22 / $148.33 / $8,639.91
| Facility | | $114.22 | $148.33 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $17.67 / $17.67
| Professional | | $17.67 | $17.67 | $17.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $30.16 / $74.98
| Facility | | $14.89 | $30.16 | $74.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $26.02 / $39.78
| Professional | | $14.13 | $26.02 | $39.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.42 / $18.12 / $30.67
| Professional | | $10.42 | $18.12 | $30.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.89 / $54.89 / $54.89
| Facility | | $54.89 | $54.89 | $54.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.25 / $61.59 / $94.71
| Facility | | $19.25 | $61.59 | $94.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $20.28 / $93.54
| Professional | | $16.98 | $20.28 | $93.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.16 / $34.40 / $74.98
| Facility | | $15.16 | $34.40 | $74.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $26.02 / $39.78
| Professional | | $14.13 | $26.02 | $39.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.65 / $22.65 / $22.65
| Facility | | $22.65 | $22.65 | $22.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.93 / $22.65 / $32.24
| Professional | | $19.93 | $22.65 | $32.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $14.50 / $39.68
| Professional | | $10.19 | $14.50 | $39.68 |