- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $30.90 / $42.66
| Facility | | $16.98 | $30.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $24.55
| Professional | | $16.98 | $16.98 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $33.88 / $69.18
| Facility | | $14.45 | $33.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $18.20
| Professional | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $17.78 / $17.78
| Facility | | $16.60 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $24.55 / $42.66
| Facility | | $17.78 | $24.55 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.98 / $20.89
| Professional | | $16.60 | $16.98 | $20.89 |
- 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
- $17.78 / $25.70 / $154.88
| Facility | | $17.78 | $25.70 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $19.05
| Professional | | $18.20 | $18.20 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $17.78
| Facility | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |