- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.06 / $0.10
| Facility | | $0.02 | $0.06 | $0.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $19.66 / $19.66
| Professional | | $0.02 | $19.66 | $19.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.86 / $11.40 / $34.32
| Professional | | $3.86 | $11.40 | $34.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $10.69 / $30.61
| Facility | | $3.24 | $10.69 | $30.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $23.96 / $25.50
| Professional | | $15.71 | $23.96 | $25.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.58 / $13.58 / $13.58
| Facility | | $13.58 | $13.58 | $13.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.44 / $91.80 / $127.56
| Facility | | $1.44 | $91.80 | $127.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.33 / $28.91 / $36.65
| Professional | | $12.33 | $28.91 | $36.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $135.76 / $135.76
| Facility | | $50.00 | $135.76 | $135.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.49 / $34.95 / $39.70
| Professional | | $21.49 | $34.95 | $39.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.50 / $22.91 / $41.69
| Facility | | $17.50 | $22.91 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $18.17 / $31.87
| Professional | | $8.65 | $18.17 | $31.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $24.01 / $127.56
| Facility | | $2.00 | $24.01 | $127.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.33 / $19.88 / $41.81
| Professional | | $12.33 | $19.88 | $41.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $11.87 / $23.94
| Professional | | $10.14 | $11.87 | $23.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.63 / $6.77 / $12.42
| Professional | | $6.63 | $6.77 | $12.42 |