- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.84 / $53.19 / $77.93
| Facility | | $15.84 | $53.19 | $77.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.23 / $15.09 / $15.84
| Professional | | $12.23 | $15.09 | $15.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.53 / $14.53 / $14.53
| Professional | | $14.53 | $14.53 | $14.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.24 / $24.21 / $61.94
| Facility | | $12.24 | $24.21 | $61.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.48 / $21.48 / $26.85
| Professional | | $21.48 | $21.48 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.57 / $10.99 / $25.23
| Professional | | $8.57 | $10.99 | $25.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.19 / $51.00 / $77.93
| Facility | | $19.19 | $51.00 | $77.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.23 / $15.28 / $76.94
| Professional | | $12.23 | $15.28 | $76.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.02 / $24.81 / $61.94
| Facility | | $13.02 | $24.81 | $61.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.48 / $21.48 / $26.85
| Professional | | $21.48 | $21.48 | $26.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.63 / $18.63 / $20.49
| Facility | | $18.63 | $18.63 | $20.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.39 / $18.63 / $20.49
| Professional | | $16.39 | $18.63 | $20.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.32 / $9.32 / $9.32
| Facility | | $9.32 | $9.32 | $9.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.82 / $11.55 / $31.67
| Professional | | $7.82 | $11.55 | $31.67 |