- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $38.90 / $91.20
| Facility | | $16.98 | $38.90 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.13 / $20.42
| Professional | | $10.00 | $14.13 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $36.31 / $48.98
| Facility | | $22.39 | $36.31 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $13.80 / $24.55
| Professional | | $8.91 | $13.80 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $29.51 / $34.67
| Professional | | $13.80 | $29.51 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $13.80 / $41.69
| Facility | | $13.80 | $13.80 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $16.60 / $22.39
| Professional | | $13.80 | $16.60 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $13.80 / $25.70
| Facility | | $13.80 | $13.80 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $19.95 / $45.71
| Facility | | $13.18 | $19.95 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $16.98 / $79.43
| Professional | | $13.80 | $16.98 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $40.74 / $56.23
| Facility | | $20.42 | $40.74 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $13.80 / $17.38
| Professional | | $10.23 | $13.80 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $21.88
| Facility | | $16.60 | $16.60 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $7.76 / $19.05
| Professional | | $5.75 | $7.76 | $19.05 |