- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.39 / $23.71 / $25.60
| Facility | | $23.39 | $23.71 | $25.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.23 / $24.66 / $32.24
| Professional | | $19.23 | $24.66 | $32.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.75 / $29.75 / $29.75
| Professional | | $29.75 | $29.75 | $29.75 |
- 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
- $42.30 / $42.30 / $42.30
| Facility | | $42.30 | $42.30 | $42.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.73 / $14.73 / $14.73
| Professional | | $14.73 | $14.73 | $14.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.28 / $168.95 / $171.48
| Facility | | $73.28 | $168.95 | $171.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.75 / $302.14 / $314.22
| Professional | | $270.75 | $302.14 | $314.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.02 / $36.10 / $67.30
| Facility | | $24.02 | $36.10 | $67.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.69 / $34.29 / $36.10
| Professional | | $30.69 | $34.29 | $36.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.38 / $40.50 / $63.17
| Professional | | $35.38 | $40.50 | $63.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.02 / $36.10 / $67.30
| Facility | | $24.02 | $36.10 | $67.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.73 / $14.73 / $30.02
| Professional | | $14.73 | $14.73 | $30.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $16.37 / $24.81
| Professional | | $12.76 | $16.37 | $24.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.10 / $36.10 / $48.74
| Professional | | $36.10 | $36.10 | $48.74 |