- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $33.88 / $60.26
| Facility | | $32.36 | $33.88 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.84 / $34.67
| Professional | | $28.18 | $28.84 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $46.77 / $58.88
| Facility | | $33.88 | $46.77 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $38.02
| Professional | | $30.20 | $30.20 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $57.54
| Facility | | $28.84 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $38.02
| Professional | | $28.84 | $28.84 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $32.36 / $46.77
| Facility | | $28.84 | $32.36 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $38.90 / $45.71
| Professional | | $0.60 | $38.90 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $46.77 / $52.48
| Facility | | $28.18 | $46.77 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $30.20 / $33.88
| Professional | | $28.84 | $30.20 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $173.78
| Professional | | $144.54 | $144.54 | $173.78 |