- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.41 / $46.41 / $46.41
| Facility | | $46.41 | $46.41 | $46.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.27 / $28.27 / $162.74
| Professional | | $28.27 | $28.27 | $162.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.06 / $36.06 / $36.06
| Facility | | $36.06 | $36.06 | $36.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.65 / $36.06 / $45.08
| Professional | | $30.65 | $36.06 | $45.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.97 / $48.83 / $148.77
| Professional | | $37.97 | $48.83 | $148.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.27 / $38.72 / $98.77
| Facility | | $28.27 | $38.72 | $98.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.42 / $52.68 / $56.97
| Professional | | $5.42 | $52.68 | $56.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.93 / $59.32 / $69.06
| Facility | | $53.93 | $59.32 | $69.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.93 / $54.26 / $64.53
| Professional | | $53.93 | $54.26 | $64.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.27 / $38.72 / $98.77
| Facility | | $28.27 | $38.72 | $98.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.06 / $49.63 / $61.14
| Professional | | $36.06 | $49.63 | $61.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.73 / $79.73 / $93.80
| Facility | | $79.73 | $79.73 | $93.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.08 / $54.08 / $54.08
| Professional | | $54.08 | $54.08 | $54.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $32.97 / $43.96
| Facility | | $4.76 | $32.97 | $43.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.75 / $27.76 / $49.51
| Professional | | $25.75 | $27.76 | $49.51 |