- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.86 / $64.37 / $78.03
| Facility | | $15.86 | $64.37 | $78.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $15.11 / $15.86
| Professional | | $12.25 | $15.11 | $15.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.55 / $14.55 / $14.55
| Professional | | $14.55 | $14.55 | $14.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.49 / $24.26 / $61.94
| Facility | | $12.49 | $24.26 | $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
- $8.58 / $11.01 / $25.27
| Professional | | $8.58 | $11.01 | $25.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.78 / $52.89 / $78.03
| Facility | | $20.78 | $52.89 | $78.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $15.30 / $77.06
| Professional | | $12.25 | $15.30 | $77.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.49 / $24.26 / $61.94
| Facility | | $12.49 | $24.26 | $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
- $18.66 / $18.66 / $18.66
| Facility | | $18.66 | $18.66 | $18.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.42 / $18.66 / $18.66
| Professional | | $16.42 | $18.66 | $18.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.20 / $11.20 / $22.39
| Facility | | $11.20 | $11.20 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.84 / $11.20 / $31.72
| Professional | | $7.84 | $11.20 | $31.72 |