- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.55 / $29.28 / $33.24
| Facility | | $22.55 | $29.28 | $33.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.55 / $29.68 / $39.57
| Professional | | $22.55 | $29.68 | $39.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.54 / $60.40 / $126.97
| Facility | | $34.54 | $60.40 | $126.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.53 / $21.53 / $24.14
| Professional | | $21.53 | $21.53 | $24.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.26 / $45.26 / $45.26
| Facility | | $45.26 | $45.26 | $45.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.14 / $29.14 / $29.14
| Facility | | $29.14 | $29.14 | $29.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.27 / $21.27 / $21.27
| Professional | | $21.27 | $21.27 | $21.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.82 / $214.99 / $214.99
| Facility | | $211.82 | $214.99 | $214.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.39 / $225.39 / $339.45
| Professional | | $225.39 | $225.39 | $339.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.45 / $31.68 / $45.26
| Facility | | $11.45 | $31.68 | $45.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.70 / $40.72 / $45.26
| Professional | | $27.70 | $40.72 | $45.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.45 / $29.68 / $45.26
| Facility | | $11.45 | $29.68 | $45.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.27 / $21.27 / $37.01
| Professional | | $21.27 | $21.27 | $37.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.99 / $24.14 / $29.23
| Professional | | $15.99 | $24.14 | $29.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.14 / $27.58 / $45.26
| Professional | | $27.14 | $27.58 | $45.26 |