- 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 / $4.25 / $11.40
| Professional | | $3.86 | $4.25 | $11.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $7.66 / $30.61
| Facility | | $2.31 | $7.66 | $30.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.82 / $23.96 / $25.50
| Professional | | $14.82 | $23.96 | $25.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.67 / $11.67 / $11.67
| Facility | | $11.67 | $11.67 | $11.67 |
- 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 / $24.78 / $36.65
| Professional | | $12.33 | $24.78 | $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
- $17.93 / $22.84 / $37.17
| Facility | | $17.93 | $22.84 | $37.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.34 / $18.17 / $32.44
| Professional | | $7.34 | $18.17 | $32.44 |
- 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 / $10.58 / $15.95
| Professional | | $10.14 | $10.58 | $15.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.53 / $5.62 / $12.42
| Professional | | $5.53 | $5.62 | $12.42 |