- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.24 / $27.96 / $36.88
| Facility | | $21.24 | $27.96 | $36.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.19 / $29.91 / $38.31
| Professional | | $24.19 | $29.91 | $38.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.88 / $49.88 / $49.88
| Facility | | $49.88 | $49.88 | $49.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.88 / $49.88 / $49.88
| Professional | | $49.88 | $49.88 | $49.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $40.07 / $40.07
| Facility | | $40.07 | $40.07 | $40.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.76 / $29.76 / $29.76
| Professional | | $29.76 | $29.76 | $29.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.37 / $81.81 / $332.00
| Facility | | $52.37 | $81.81 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.36 / $44.99 / $68.88
| Professional | | $36.36 | $44.99 | $68.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.74 / $31.74 / $37.77
| Facility | | $31.74 | $31.74 | $37.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.97 / $37.14 / $72.87
| Professional | | $27.97 | $37.14 | $72.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.07 / $40.07 / $40.07
| Facility | | $40.07 | $40.07 | $40.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.76 / $36.36 / $77.72
| Professional | | $29.76 | $36.36 | $77.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.19 / $41.26 / $80.53
| Professional | | $26.19 | $41.26 | $80.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.74 / $36.92 / $37.77
| Facility | | $31.74 | $36.92 | $37.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.27 / $37.14 / $79.22
| Professional | | $30.27 | $37.14 | $79.22 |