- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.61 / $50.03 / $118.03
| Facility | | $37.61 | $50.03 | $118.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.35 / $37.61 / $45.56
| Professional | | $32.35 | $37.61 | $45.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.32 / $74.20 / $148.07
| Facility | | $29.32 | $74.20 | $148.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.78 / $35.78 / $35.78
| Professional | | $35.78 | $35.78 | $35.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.66 / $23.27 / $37.58
| Professional | | $21.66 | $23.27 | $37.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.80 / $24.80 / $24.80
| Facility | | $24.80 | $24.80 | $24.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.25 / $35.25 / $35.25
| Facility | | $35.25 | $35.25 | $35.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.00 / $35.25 / $35.25
| Professional | | $32.00 | $35.25 | $35.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.51 / $100.00 / $133.13
| Facility | | $41.51 | $100.00 | $133.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.57 / $36.54 / $53.80
| Facility | | $24.57 | $36.54 | $53.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.31 / $22.31 / $22.31
| Professional | | $22.31 | $22.31 | $22.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.03 / $35.25 / $53.80
| Facility | | $28.03 | $35.25 | $53.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.54 / $35.25 / $35.25
| Professional | | $31.54 | $35.25 | $35.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.90 / $37.13 / $37.61
| Professional | | $29.90 | $37.13 | $37.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.30 / $30.30 / $40.90
| Professional | | $30.30 | $30.30 | $40.90 |