- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $43.65 / $43.65
| Facility | | $42.66 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $39.81 / $50.12
| Professional | | $22.91 | $39.81 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $23.44 / $23.44
| Facility | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $19.05 / $61.66
| Professional | | $15.49 | $19.05 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Facility | | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Professional | | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $41.69 / $63.10
| Facility | | $23.99 | $41.69 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $40.74 / $54.95
| Professional | | $22.91 | $40.74 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $151.36 / $177.83
| Professional | | $131.83 | $151.36 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $41.69 / $61.66
| Facility | | $20.89 | $41.69 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $61.66
| Professional | | $16.98 | $16.98 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $58.88 / $77.62
| Facility | | $31.62 | $58.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $53.70 / $87.10
| Professional | | $38.90 | $53.70 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $38.02
| Professional | | $32.36 | $32.36 | $38.02 |