- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $21.88 / $50.12
| Facility | | $2.57 | $21.88 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $53.70
| Professional | | $16.98 | $16.98 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $44.67 / $58.88
| Facility | | $14.13 | $44.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.78 / $33.88
| Professional | | $17.38 | $17.78 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $33.88
| Facility | | $17.38 | $17.38 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Facility | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $56.23 / $8,511.38
| Facility | | $20.89 | $56.23 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $33.88
| Professional | | $17.78 | $17.78 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $29.51 / $83.18
| Facility | | $26.92 | $29.51 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $44.67 / $58.88
| Facility | | $14.13 | $44.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.78 / $33.88
| Professional | | $17.38 | $17.78 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $26.92 / $34.67
| Facility | | $16.22 | $26.92 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $33.88
| Professional | | $17.38 | $17.38 | $33.88 |