- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.59 / $71.48 / $71.48
| Facility | | $60.59 | $71.48 | $71.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $12.90 / $22.74
| Professional | | $8.69 | $12.90 | $22.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.40 / $79.89 / $112.96
| Facility | | $57.40 | $79.89 | $112.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.19 / $14.19 / $14.19
| Professional | | $14.19 | $14.19 | $14.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.31 / $21.31 / $29.54
| Facility | | $21.31 | $21.31 | $29.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.97 / $7.97 / $7.97
| Professional | | $7.97 | $7.97 | $7.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.10 / $24.56 / $44.93
| Professional | | $19.10 | $24.56 | $44.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.48 / $71.48 / $71.48
| Facility | | $71.48 | $71.48 | $71.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.81 / $13.05 / $75.30
| Professional | | $8.81 | $13.05 | $75.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $16.00 / $18.89
| Professional | | $12.80 | $16.00 | $18.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.31 / $21.31 / $29.54
| Facility | | $21.31 | $21.31 | $29.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.97 / $7.97 / $7.97
| Professional | | $7.97 | $7.97 | $7.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $17.30 / $17.30
| Professional | | $14.79 | $17.30 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.35 / $9.07 / $23.28
| Professional | | $6.35 | $9.07 | $23.28 |