- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.20 / $27.58 / $69.79
| Facility | | $12.20 | $27.58 | $69.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.24 / $13.74 / $15.76
| Professional | | $10.24 | $13.74 | $15.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.76 / $15.76 / $40.98
| Facility | | $15.76 | $15.76 | $40.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $7.78 / $23.70
| Professional | | $3.89 | $7.78 | $23.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $15.76 / $15.76
| Facility | | $9.46 | $15.76 | $15.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.50 / $15.76 / $15.76
| Professional | | $11.50 | $15.76 | $15.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.02 / $31.79 / $82.66
| Facility | | $11.02 | $31.79 | $82.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.71 / $17.89 / $113.63
| Professional | | $11.71 | $17.89 | $113.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.10 / $23.64 / $332.00
| Facility | | $14.10 | $23.64 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $9.38 / $28.84
| Professional | | $6.30 | $9.38 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.76 / $5.76 / $5.76
| Facility | | $5.76 | $5.76 | $5.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.76 / $8.52 / $17.70
| Professional | | $5.76 | $8.52 | $17.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.03 / $30.60 / $69.88
| Facility | | $13.03 | $30.60 | $69.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.36 / $38.29 / $212.06
| Facility | | $15.36 | $38.29 | $212.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $13.78 / $32.47
| Professional | | $4.90 | $13.78 | $32.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.58 / $7.56 / $23.15
| Professional | | $5.58 | $7.56 | $23.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.39 / $18.12 / $23.65
| Facility | | $17.39 | $18.12 | $23.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.79 / $14.97 / $21.73
| Professional | | $5.79 | $14.97 | $21.73 |