- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $38.02 / $60.26
| Facility | | $29.51 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $33.88 / $54.95
| Professional | | $33.11 | $33.88 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $38.90 / $52.48
| Facility | | $26.30 | $38.90 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $26.30 / $35.48
| Professional | | $25.12 | $26.30 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $33.88
| Facility | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $44.67
| Professional | | $33.88 | $33.88 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $40.74 / $40.74
| Facility | | $33.88 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $53.70 / $60.26
| Facility | | $25.70 | $53.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.88 / $41.69
| Professional | | $32.36 | $33.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |