- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.44 / $21.44 / $23.58
| Facility | | $21.44 | $21.44 | $23.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.13 / $23.50 / $31.32
| Professional | | $18.13 | $23.50 | $31.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.53 / $151.53 / $151.53
| Facility | | $151.53 | $151.53 | $151.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.11 / $98.09 / $187.97
| Professional | | $29.11 | $98.09 | $187.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.32 / $47.92 / $71.55
| Professional | | $29.32 | $47.92 | $71.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.16 / $29.16 / $41.91
| Professional | | $29.16 | $29.16 | $41.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.76 / $35.68 / $37.99
| Facility | | $26.76 | $35.68 | $37.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.76 / $35.68 / $51.90
| Professional | | $26.76 | $35.68 | $51.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $65.48 / $88.91
| Professional | | $33.11 | $65.48 | $88.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.79 / $40.71 / $81.27
| Professional | | $30.79 | $40.71 | $81.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.53 / $151.53 / $151.53
| Facility | | $151.53 | $151.53 | $151.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.11 / $98.09 / $187.97
| Professional | | $29.11 | $98.09 | $187.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.04 / $33.19 / $48.18
| Professional | | $26.04 | $33.19 | $48.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.09 / $40.09 / $40.09
| Facility | | $40.09 | $40.09 | $40.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.71 / $39.72 / $93.81
| Professional | | $26.71 | $39.72 | $93.81 |