- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.98 / $71.04 / $142.08
| Facility | | $17.98 | $71.04 | $142.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.95 / $17.98 / $44.96
| Professional | | $14.95 | $17.98 | $44.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.08 / $47.52 / $59.92
| Facility | | $38.08 | $47.52 | $59.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.61 / $15.34 / $15.34
| Professional | | $14.61 | $15.34 | $15.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.69 / $18.57 / $58.72
| Facility | | $11.69 | $18.57 | $58.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $18.00 / $32.01
| Professional | | $10.48 | $18.00 | $32.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.24 / $11.24 / $21.36
| Facility | | $11.24 | $11.24 | $21.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $22.71 / $28.44
| Professional | | $5.80 | $22.71 | $28.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.15 / $26.53 / $28.30
| Facility | | $14.15 | $26.53 | $28.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $15.75 / $22.48
| Professional | | $4.05 | $15.75 | $22.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $106.78 / $106.78
| Facility | | $80.00 | $106.78 | $106.78 |