- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.64 / $63.47 / $76.97
| Facility | | $15.64 | $63.47 | $76.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.57 / $14.54 / $15.64
| Professional | | $9.57 | $14.54 | $15.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.35 / $14.35 / $14.35
| Professional | | $14.35 | $14.35 | $14.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $23.91 / $60.85
| Facility | | $12.32 | $23.91 | $60.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.06 / $21.06 / $26.33
| Professional | | $21.06 | $21.06 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.46 / $10.86 / $24.91
| Professional | | $8.46 | $10.86 | $24.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.49 / $52.15 / $76.97
| Facility | | $20.49 | $52.15 | $76.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.08 / $15.09 / $75.98
| Professional | | $12.08 | $15.09 | $75.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $23.30 / $60.85
| Facility | | $12.32 | $23.30 | $60.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.06 / $21.06 / $26.33
| Professional | | $21.06 | $21.06 | $26.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.39 / $18.39 / $20.23
| Facility | | $18.39 | $18.39 | $20.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.19 / $18.39 / $20.23
| Professional | | $16.19 | $18.39 | $20.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.73 / $7.73 / $7.73
| Facility | | $7.73 | $7.73 | $7.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $11.04 / $31.28
| Professional | | $7.73 | $11.04 | $31.28 |