- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.65 / $32.27 / $32.89
| Facility | | $31.65 | $32.27 | $32.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.78 / $32.89 / $53.36
| Professional | | $29.78 | $32.89 | $53.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.19 / $42.19 / $42.19
| Professional | | $42.19 | $42.19 | $42.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.86 / $70.86 / $70.86
| Facility | | $70.86 | $70.86 | $70.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.35 / $39.35 / $39.35
| Facility | | $39.35 | $39.35 | $39.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.73 / $28.73 / $39.35
| Professional | | $28.73 | $28.73 | $39.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.49 / $328.21 / $328.21
| Facility | | $118.49 | $328.21 | $328.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.92 / $354.92 / $515.85
| Professional | | $354.92 | $354.92 | $515.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.28 / $47.34 / $70.86
| Facility | | $20.28 | $47.34 | $70.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.28 / $60.23 / $70.86
| Professional | | $20.28 | $60.23 | $70.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.21 / $72.28 / $159.44
| Professional | | $54.21 | $72.28 | $159.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.28 / $42.59 / $70.86
| Facility | | $20.28 | $42.59 | $70.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.73 / $28.73 / $40.53
| Professional | | $28.73 | $28.73 | $40.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.18 / $37.86 / $45.07
| Professional | | $26.18 | $37.86 | $45.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.72 / $38.36 / $70.86
| Professional | | $37.72 | $38.36 | $70.86 |