- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $33.88 / $66.07
| Facility | | $12.88 | $33.88 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $15.14 / $26.92
| Professional | | $10.96 | $15.14 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $34.67 / $42.66
| Professional | | $21.88 | $34.67 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $32.36 / $114.82
| Professional | | $19.95 | $32.36 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $23.44 / $56.23
| Facility | | $17.78 | $23.44 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $21.38 / $46.77
| Professional | | $10.72 | $21.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.88 / $23.44
| Professional | | $21.38 | $21.88 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $39.81
| Facility | | $17.78 | $17.78 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $15.14 / $43.65
| Professional | | $10.72 | $15.14 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $17.78 / $17.78
| Professional | | $14.13 | $17.78 | $17.78 |