- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $30.20 / $154.88
| Facility | | $15.14 | $30.20 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.96 / $22.91
| Professional | | $7.94 | $10.96 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $31.62 / $43.65
| Facility | | $19.50 | $31.62 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $12.02 / $21.88
| Professional | | $7.94 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $25.70 / $30.90
| Professional | | $12.02 | $25.70 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $27.54
| Facility | | $12.02 | $12.02 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $23.99
| Professional | | $12.02 | $15.14 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $26.92
| Facility | | $12.02 | $12.02 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $17.38 / $39.81
| Facility | | $11.75 | $17.38 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $79.43
| Professional | | $12.02 | $15.14 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $36.31 / $50.12
| Facility | | $18.20 | $36.31 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $15.49
| Professional | | $8.91 | $12.02 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $19.05
| Facility | | $14.45 | $14.45 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.92 / $16.98
| Professional | | $5.01 | $6.92 | $16.98 |