- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $23.99 / $70.79
| Facility | | $19.50 | $23.99 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $15.14 / $23.99
| Professional | | $10.00 | $15.14 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $41.69 / $56.23
| Facility | | $25.70 | $41.69 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $15.85 / $28.18
| Professional | | $10.47 | $15.85 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $33.88 / $39.81
| Professional | | $15.85 | $33.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $21.88
| Facility | | $15.85 | $15.85 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $19.50 / $31.62
| Professional | | $15.85 | $19.50 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $34.67
| Facility | | $15.85 | $15.85 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $22.91 / $52.48
| Facility | | $15.14 | $22.91 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $19.50 / $79.43
| Professional | | $15.85 | $19.50 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $46.77 / $64.57
| Facility | | $23.44 | $46.77 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $15.85 / $19.95
| Professional | | $11.75 | $15.85 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $25.12
| Facility | | $19.05 | $19.05 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $8.91 / $21.88
| Professional | | $6.61 | $8.91 | $21.88 |