- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $32.36
| Facility | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $25.70 / $38.90
| Professional | | $12.88 | $25.70 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $28.84
| Facility | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $21.38
| Professional | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $87.10 / $104.71
| Professional | | $34.67 | $87.10 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $43.65
| Facility | | $32.36 | $33.11 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $34.67 / $47.86
| Professional | | $31.62 | $34.67 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $44.67 / $45.71
| Facility | | $34.67 | $44.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $45.71 / $45.71
| Professional | | $38.02 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $36.31 / $54.95
| Facility | | $24.55 | $36.31 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $42.66 / $75.86
| Professional | | $21.38 | $42.66 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $60.26 / $169.82
| Facility | | $37.15 | $60.26 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $50.12 / $50.12
| Professional | | $45.71 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $33.88
| Facility | | $30.90 | $30.90 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $19.05 / $37.15
| Professional | | $16.22 | $19.05 | $37.15 |