- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.66 / $25.52 / $28.97
| Facility | | $19.66 | $25.52 | $28.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.66 / $25.87 / $34.49
| Professional | | $19.66 | $25.87 | $34.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.72 / $22.50 / $25.16
| Facility | | $20.72 | $22.50 | $25.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.38 / $39.38 / $39.38
| Facility | | $39.38 | $39.38 | $39.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.07 / $26.07 / $26.85
| Facility | | $26.07 | $26.07 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.07 / $22.16 / $22.16
| Professional | | $16.07 | $22.16 | $22.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.95 / $187.06 / $187.06
| Facility | | $184.95 | $187.06 | $187.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.11 / $196.11 / $295.35
| Professional | | $196.11 | $196.11 | $295.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.78 / $28.97 / $39.38
| Facility | | $10.78 | $28.97 | $39.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.10 / $35.44 / $39.38
| Professional | | $24.10 | $35.44 | $39.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.78 / $28.19 / $39.38
| Facility | | $10.78 | $28.19 | $39.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.07 / $22.16 / $30.83
| Professional | | $16.07 | $22.16 | $30.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.92 / $18.17 / $23.96
| Professional | | $13.92 | $18.17 | $23.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.73 / $19.73 / $39.38
| Professional | | $19.73 | $19.73 | $39.38 |