- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.03 / $25.33 / $56.73
| Facility | | $15.03 | $25.33 | $56.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.61 / $20.25 / $30.39
| Professional | | $16.61 | $20.25 | $30.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.67 / $20.67 / $20.67
| Professional | | $20.67 | $20.67 | $20.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $22.96 / $57.51
| Professional | | $11.48 | $22.96 | $57.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.16 / $20.26 / $20.26
| Facility | | $12.16 | $20.26 | $20.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $20.26 / $20.26
| Professional | | $14.79 | $20.26 | $20.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.99 / $47.24 / $49.38
| Facility | | $40.99 | $47.24 | $49.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.58 / $28.83 / $63.24
| Professional | | $13.58 | $28.83 | $63.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.70 / $26.70 / $137.57
| Facility | | $26.70 | $26.70 | $137.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.18 / $20.26 / $38.49
| Professional | | $14.18 | $20.26 | $38.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.25 / $20.26 / $36.74
| Professional | | $19.25 | $20.26 | $36.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.24 / $47.24 / $49.38
| Facility | | $47.24 | $47.24 | $49.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.84 / $32.15 / $65.30
| Professional | | $13.84 | $32.15 | $65.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $14.01 / $38.49
| Professional | | $9.44 | $14.01 | $38.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.25 / $21.85 / $53.84
| Professional | | $19.25 | $21.85 | $53.84 |