- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.23 / $20.23 / $22.94
| Facility | | $20.23 | $20.23 | $22.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.98 / $22.06 / $28.78
| Professional | | $17.98 | $22.06 | $28.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.94 / $101.94 / $101.94
| Facility | | $101.94 | $101.94 | $101.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $34.03 / $131.99
| Professional | | $19.64 | $34.03 | $131.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.62 / $53.23 / $63.29
| Facility | | $23.62 | $53.23 | $63.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.07 / $30.78 / $51.83
| Professional | | $20.07 | $30.78 | $51.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.00 / $26.00 / $62.54
| Professional | | $16.00 | $26.00 | $62.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.22 / $26.22 / $27.52
| Facility | | $26.22 | $26.22 | $27.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.50 / $26.22 / $39.11
| Professional | | $15.50 | $26.22 | $39.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.12 / $46.02 / $65.31
| Professional | | $22.12 | $46.02 | $65.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.20 / $231.20 / $231.20
| Professional | | $231.20 | $231.20 | $231.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.94 / $101.94 / $101.94
| Facility | | $101.94 | $101.94 | $101.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.69 / $30.59 / $146.12
| Professional | | $19.69 | $30.59 | $146.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.03 / $25.84 / $58.30
| Professional | | $19.03 | $25.84 | $58.30 |