- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $15.14 / $20.89
| Professional | | $7.08 | $15.14 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $46.77 / $46.77
| Facility | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $16.98 / $26.92
| Professional | | $7.76 | $16.98 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $70.79 / $95.50
| Professional | | $28.84 | $70.79 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $34.67 / $34.67
| Facility | | $34.67 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $9.33
| Professional | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $20.42 / $31.62
| Professional | | $13.80 | $20.42 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $23.44 / $26.30
| Professional | | $19.95 | $23.44 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $123.03
| Facility | | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Professional | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $22.39 / $26.30
| Facility | | $10.72 | $22.39 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $35.48
| Professional | | $9.33 | $9.33 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $47.86 / $47.86
| Professional | | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $9.55 / $22.39
| Professional | | $8.71 | $9.55 | $22.39 |