- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.75 / $14.53 / $15.05
| Facility | | $13.75 | $14.53 | $15.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.69 / $14.81 / $21.33
| Professional | | $12.69 | $14.81 | $21.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $20.00 / $20.00
| Professional | | $20.00 | $20.00 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.60 / $27.60 / $27.60
| Facility | | $27.60 | $27.60 | $27.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.14 / $20.14 / $27.60
| Professional | | $20.14 | $20.14 | $27.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.59 / $146.78 / $146.78
| Facility | | $141.59 | $146.78 | $146.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.28 / $194.77 / $226.28
| Professional | | $187.28 | $194.77 | $226.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.16 / $24.45 / $44.22
| Facility | | $13.16 | $24.45 | $44.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.44 / $13.16 / $24.45
| Professional | | $11.44 | $13.16 | $24.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.05 / $29.42 / $32.86
| Professional | | $28.05 | $29.42 | $32.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.16 / $24.45 / $42.72
| Facility | | $13.16 | $24.45 | $42.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.14 / $20.14 / $27.60
| Professional | | $20.14 | $20.14 | $27.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.44 / $17.18 / $31.94
| Professional | | $14.44 | $17.18 | $31.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.11 / $39.11 / $56.42
| Professional | | $39.11 | $39.11 | $56.42 |