- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.83 / $27.35 / $27.88
| Facility | | $26.83 | $27.35 | $27.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.25 / $27.88 / $45.24
| Professional | | $25.25 | $27.88 | $45.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.59 / $28.59 / $35.77
| Professional | | $28.59 | $28.59 | $35.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.08 / $60.08 / $60.08
| Facility | | $60.08 | $60.08 | $60.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.35 / $33.35 / $33.35
| Facility | | $33.35 | $33.35 | $33.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.35 / $24.35 / $24.35
| Professional | | $24.35 | $24.35 | $24.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.40 / $278.23 / $278.23
| Facility | | $100.40 | $278.23 | $278.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.94 / $300.94 / $437.18
| Professional | | $300.94 | $300.94 | $437.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.19 / $40.13 / $60.08
| Facility | | $17.19 | $40.13 | $60.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.19 / $54.07 / $60.08
| Professional | | $17.19 | $54.07 | $60.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.96 / $61.28 / $135.18
| Professional | | $45.96 | $61.28 | $135.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.19 / $36.11 / $60.08
| Facility | | $17.19 | $36.11 | $60.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.35 / $24.35 / $48.46
| Professional | | $24.35 | $24.35 | $48.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.49 / $60.49 / $71.17
| Facility | | $60.49 | $60.49 | $71.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.19 / $32.09 / $38.20
| Professional | | $22.19 | $32.09 | $38.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.25 / $31.98 / $60.08
| Professional | | $31.25 | $31.98 | $60.08 |