- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.57 / $18.93 / $19.30
| Facility | | $18.57 | $18.93 | $19.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $19.30 / $31.31
| Professional | | $17.48 | $19.30 | $31.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.79 / $19.79 / $19.79
| Professional | | $19.79 | $19.79 | $19.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.58 / $41.58 / $41.58
| Facility | | $41.58 | $41.58 | $41.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.09 / $23.09 / $23.09
| Facility | | $23.09 | $23.09 | $23.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $23.09
| Professional | | $16.86 | $16.86 | $23.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.02 / $192.63 / $192.63
| Facility | | $84.02 | $192.63 | $192.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.46 / $208.46 / $302.63
| Professional | | $208.46 | $208.46 | $302.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.90 / $27.78 / $41.58
| Facility | | $11.90 | $27.78 | $41.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.90 / $37.42 / $41.58
| Professional | | $11.90 | $37.42 | $41.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.18 / $42.41 / $93.56
| Professional | | $31.18 | $42.41 | $93.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.90 / $25.78 / $41.58
| Facility | | $11.90 | $25.78 | $41.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $24.61
| Professional | | $16.86 | $16.86 | $24.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.36 / $22.21 / $26.45
| Professional | | $15.36 | $22.21 | $26.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.31 / $22.14 / $41.58
| Professional | | $13.31 | $22.14 | $41.58 |