- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $38.90 / $151.36
| Facility | | $15.85 | $38.90 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $25.70
| Professional | | $8.91 | $12.02 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $35.48 / $48.98
| Facility | | $21.88 | $35.48 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $13.49 / $24.55
| Professional | | $8.91 | $13.49 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $29.51 / $34.67
| Professional | | $13.49 | $29.51 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $87.10
| Facility | | $13.49 | $13.49 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $16.22 / $22.39
| Professional | | $12.02 | $16.22 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $25.70
| Facility | | $13.49 | $13.49 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $19.50 / $45.71
| Facility | | $13.18 | $19.50 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $16.98 / $79.43
| Professional | | $13.49 | $16.98 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $40.74 / $56.23
| Facility | | $20.42 | $40.74 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $13.49 / $17.38
| Professional | | $10.23 | $13.49 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $21.88
| Facility | | $16.22 | $16.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $7.76 / $16.22
| Professional | | $5.75 | $7.76 | $16.22 |