- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.35 / $30.21 / $30.21
| Facility | | $28.35 | $30.21 | $30.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.35 / $30.21 / $38.20
| Professional | | $28.35 | $30.21 | $38.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.19 / $30.82 / $30.82
| Professional | | $26.19 | $30.82 | $30.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.29 / $35.29 / $36.97
| Facility | | $35.29 | $35.29 | $36.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.40 / $42.40 / $42.40
| Facility | | $42.40 | $42.40 | $42.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.84 / $31.84 / $31.84
| Professional | | $31.84 | $31.84 | $31.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.96 / $180.58 / $180.58
| Facility | | $60.96 | $180.58 | $180.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.48 / $226.80 / $290.77
| Professional | | $223.48 | $226.80 | $290.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.47 / $36.34 / $79.31
| Facility | | $28.47 | $36.34 | $79.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.60 / $50.18 / $64.37
| Professional | | $40.60 | $50.18 | $64.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.50 / $86.70 / $86.70
| Professional | | $70.50 | $86.70 | $86.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.47 / $36.34 / $79.31
| Facility | | $28.47 | $36.34 | $79.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.84 / $31.84 / $84.08
| Professional | | $31.84 | $31.84 | $84.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.81 / $38.94 / $60.33
| Professional | | $29.81 | $38.94 | $60.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.54 / $34.64 / $48.16
| Professional | | $29.54 | $34.64 | $48.16 |