- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $21.88
| Professional | | $9.33 | $15.85 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $46.77
| Professional | | $21.38 | $21.38 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $17.78 / $23.99
| Facility | | $2.40 | $17.78 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $17.78 / $23.99
| Professional | | $2.40 | $17.78 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $24.55
| Facility | | $18.62 | $18.62 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $18.62 / $24.55
| Professional | | $15.85 | $18.62 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $66.07 / $66.07
| Facility | | $66.07 | $66.07 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $19.05 / $26.92
| Professional | | $15.14 | $19.05 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $22.39 / $22.39
| Facility | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $22.39 / $23.99
| Professional | | $19.95 | $22.39 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $22.39 / $22.39
| Professional | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.29 / $12.02 / $20.89
| Facility | | $1.29 | $12.02 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $23.44
| Professional | | $9.33 | $15.85 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $19.95 / $22.39
| Facility | | $19.50 | $19.95 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $20.89 / $22.39
| Professional | | $19.95 | $20.89 | $22.39 |