- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.47 / $27.47 / $27.47
| Facility | | $27.47 | $27.47 | $27.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.02 / $27.47 / $36.94
| Professional | | $16.02 | $27.47 | $36.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.67 / $45.67 / $45.67
| Facility | | $45.67 | $45.67 | $45.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.15 / $36.15 / $36.15
| Professional | | $36.15 | $36.15 | $36.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.73 / $31.73 / $34.50
| Professional | | $31.73 | $31.73 | $34.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.99 / $29.99 / $39.36
| Facility | | $29.99 | $29.99 | $39.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.49 / $29.99 / $39.36
| Professional | | $25.49 | $29.99 | $39.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.73 / $37.25 / $50.35
| Professional | | $31.73 | $37.25 | $50.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.56 / $27.47 / $56.82
| Facility | | $15.56 | $27.47 | $56.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.71 / $42.71 / $42.71
| Professional | | $42.71 | $42.71 | $42.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.93 / $5.49 / $43.93
| Facility | | $2.93 | $5.49 | $43.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.93 / $5.49 / $43.93
| Professional | | $2.93 | $5.49 | $43.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.82 / $16.34 / $28.04
| Facility | | $1.82 | $16.34 | $28.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.75 / $25.99 / $37.14
| Professional | | $20.75 | $25.99 | $37.14 |