- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $38.02 / $52.48
| Facility | | $20.42 | $38.02 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $20.42 / $32.36
| Professional | | $19.95 | $20.42 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $20.42 / $85.11
| Facility | | $19.05 | $20.42 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $26.92
| Facility | | $20.42 | $20.42 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $21.38 / $21.38
| Professional | | $10.72 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $60.26 / $93.33
| Professional | | $54.95 | $60.26 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $30.20 / $53.70
| Facility | | $26.92 | $30.20 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $21.38 / $32.36
| Professional | | $20.42 | $21.38 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $21.38
| Professional | | $20.42 | $20.42 | $21.38 |