- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.19 / $44.91 / $116.64
| Facility | | $18.19 | $44.91 | $116.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.44 / $18.29 / $38.74
| Professional | | $14.44 | $18.29 | $38.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.47 / $75.06 / $134.97
| Facility | | $26.47 | $75.06 | $134.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $12.75 / $23.10
| Professional | | $5.00 | $12.75 | $23.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $38.50 / $108.22
| Facility | | $24.06 | $38.50 | $108.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.45 / $20.45 / $24.06
| Facility | | $20.45 | $20.45 | $24.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.80 / $40.59 / $106.51
| Facility | | $16.80 | $40.59 | $106.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $13.10 / $36.65
| Professional | | $11.25 | $13.10 | $36.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.01 / $114.29 / $114.29
| Facility | | $58.01 | $114.29 | $114.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.52 / $24.06 / $28.87
| Facility | | $17.52 | $24.06 | $28.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.45 / $24.06 / $24.06
| Professional | | $20.45 | $24.06 | $24.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.52 / $24.06 / $55.00
| Facility | | $17.52 | $24.06 | $55.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $13.57 / $25.49
| Professional | | $11.25 | $13.57 | $25.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $10.35 / $19.91
| Professional | | $10.09 | $10.35 | $19.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.38 / $9.61 / $24.06
| Professional | | $9.38 | $9.61 | $24.06 |