- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.43 / $47.09 / $67.52
| Facility | | $22.43 | $47.09 | $67.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.54 / $22.54 / $26.87
| Professional | | $22.54 | $22.54 | $26.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.87 / $24.45 / $8,459.92
| Facility | | $20.87 | $24.45 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.39 / $23.39 / $23.39
| Professional | | $23.39 | $23.39 | $23.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.26 / $22.54 / $22.54
| Facility | | $21.26 | $22.54 | $22.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.54 / $22.54 / $23.21
| Professional | | $22.54 | $22.54 | $23.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.54 / $22.54 / $28.19
| Professional | | $22.54 | $22.54 | $28.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.73 / $52.73 / $54.78
| Facility | | $52.73 | $52.73 | $54.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.43 / $34.65 / $67.52
| Facility | | $22.43 | $34.65 | $67.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.43 / $22.76 / $37.90
| Professional | | $22.43 | $22.76 | $37.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $33.10 / $40.29
| Professional | | $27.40 | $33.10 | $40.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.26 / $22.54 / $22.54
| Facility | | $21.26 | $22.54 | $22.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.54 / $22.54 / $23.39
| Professional | | $22.54 | $22.54 | $23.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.00 / $19.00 / $22.05
| Facility | | $19.00 | $19.00 | $22.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $19.00 / $22.05
| Professional | | $19.00 | $19.00 | $22.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.19 / $23.89 / $29.41
| Professional | | $22.19 | $23.89 | $29.41 |