- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.18 / $16.39 / $17.71
| Facility | | $16.18 | $16.39 | $17.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.00 / $16.88 / $21.87
| Professional | | $13.00 | $16.88 | $21.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.58 / $20.58 / $20.58
| Professional | | $20.58 | $20.58 | $20.58 |
- 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
- $29.27 / $29.27 / $29.27
| Facility | | $29.27 | $29.27 | $29.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $10.19 / $10.19
| Professional | | $10.19 | $10.19 | $10.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.71 / $116.91 / $118.66
| Facility | | $50.71 | $116.91 | $118.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.35 / $197.89 / $205.81
| Professional | | $187.35 | $197.89 | $205.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.62 / $24.98 / $46.55
| Facility | | $16.62 | $24.98 | $46.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.23 / $23.73 / $24.98
| Professional | | $21.23 | $23.73 | $24.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.48 / $28.03 / $43.72
| Professional | | $24.48 | $28.03 | $43.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.62 / $24.98 / $46.55
| Facility | | $16.62 | $24.98 | $46.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $10.19 / $20.77
| Professional | | $10.19 | $10.19 | $20.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $11.33 / $17.16
| Professional | | $8.83 | $11.33 | $17.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.98 / $24.98 / $33.72
| Professional | | $24.98 | $24.98 | $33.72 |