- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $25.70 / $79.43
| Facility | | $11.22 | $25.70 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.88 / $19.05
| Professional | | $10.00 | $12.88 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $40.74 / $64.57
| Facility | | $14.13 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Facility | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $16.60 / $77.62
| Facility | | $11.22 | $16.60 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $20.89 / $26.30
| Professional | | $9.12 | $20.89 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $17.38 / $33.88
| Facility | | $11.48 | $17.38 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.13 / $19.95
| Professional | | $10.00 | $14.13 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $12.88
| Professional | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $17.38 / $39.81
| Facility | | $10.47 | $17.38 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $16.60 / $32.36
| Professional | | $9.12 | $16.60 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $8.13 / $17.38
| Facility | | $6.17 | $8.13 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $7.24 / $10.47
| Professional | | $7.24 | $7.24 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $4.68 / $17.38
| Professional | | $4.68 | $4.68 | $17.38 |