- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.09 / $39.25 / $81.42
| Facility | | $19.09 | $39.25 | $81.42 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $11.33 / $11.33 / $11.33
| Facility | 25 | $11.33 | $11.33 | $11.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.87 / $26.53 / $58.55
| Professional | | $21.87 | $26.53 | $58.55 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $25.11 / $61.05 / $71.25
| Professional | 25 | $25.11 | $61.05 | $71.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.42 / $35.59 / $45.34
| Professional | | $25.42 | $35.59 | $45.34 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $29.24 / $44.87 / $49.50
| Professional | 25 | $29.24 | $44.87 | $49.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.16 / $41.94 / $60.44
| Professional | | $29.16 | $41.94 | $60.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.15 / $33.15 / $33.15
| Facility | | $33.15 | $33.15 | $33.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.39 / $35.54 / $56.68
| Professional | | $24.39 | $35.54 | $56.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.33 / $27.99 / $45.14
| Facility | | $23.33 | $27.99 | $45.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $35.00 / $38.00
| Professional | | $19.05 | $35.00 | $38.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.84 / $39.35 / $48.68
| Professional | | $27.84 | $39.35 | $48.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.04 / $29.59 / $53.65
| Professional | | $22.04 | $29.59 | $53.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.94 / $238.94 / $238.94
| Facility | | $238.94 | $238.94 | $238.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.78 / $342.78 / $342.78
| Professional | | $342.78 | $342.78 | $342.78 |