- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.63 / $23.65 / $52.28
| Facility | | $23.63 | $23.65 | $52.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.63 / $23.65 / $39.65
| Professional | | $23.63 | $23.65 | $39.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.07 / $25.43 / $26.77
| Facility | | $20.07 | $25.43 | $26.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.41 / $26.48 / $26.77
| Professional | | $25.41 | $26.48 | $26.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.59 / $23.65 / $29.48
| Professional | | $23.59 | $23.65 | $29.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.60 / $23.63 / $115.65
| Facility | | $22.60 | $23.63 | $115.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.13 / $23.63 / $27.16
| Professional | | $23.13 | $23.63 | $27.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.76 / $37.29 / $54.45
| Facility | | $27.76 | $37.29 | $54.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.89 / $27.79 / $34.76
| Professional | | $25.89 | $27.79 | $34.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.65 / $23.65 / $23.65
| Facility | | $23.65 | $23.65 | $23.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.47 / $23.65 / $26.02
| Professional | | $22.47 | $23.65 | $26.02 |