- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.29 / $27.74 / $76.88
| Facility | | $11.29 | $27.74 | $76.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $9.21 / $12.63
| Professional | | $8.32 | $9.21 | $12.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $14.86 / $14.86
| Professional | | $12.63 | $14.86 | $14.86 |
- 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
- $9.90 / $34.09 / $66.41
| Facility | | $9.90 | $34.09 | $66.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.88 / $17.95 / $21.50
| Professional | | $7.88 | $17.95 | $21.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.86 / $70.59 / $70.59
| Facility | | $25.86 | $70.59 | $70.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.30 / $74.30 / $111.45
| Professional | | $74.30 | $74.30 | $111.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.06 / $14.86 / $22.29
| Facility | | $9.06 | $14.86 | $22.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.12 / $14.86 / $18.57
| Professional | | $14.12 | $14.86 | $18.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.37 / $26.53 / $52.01
| Professional | | $13.37 | $26.53 | $52.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.09 / $15.62 / $53.59
| Facility | | $10.09 | $15.62 | $53.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.89 / $17.98 / $26.01
| Professional | | $11.89 | $17.98 | $26.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $6.24 / $10.22
| Professional | | $6.24 | $6.24 | $10.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $6.61 / $14.86
| Professional | | $6.61 | $6.61 | $14.86 |