- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.14 / $39.51 / $165.55
| Facility | | $9.14 | $39.51 | $165.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $10.78 / $21.00
| Professional | | $7.25 | $10.78 | $21.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $7.25 / $7.56
| Professional | | $5.80 | $7.25 | $7.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.54 / $37.96 / $67.81
| Facility | | $13.54 | $37.96 | $67.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.41 / $11.97
| Professional | | $5.00 | $6.41 | $11.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.46 / $10.88 / $19.34
| Professional | | $8.46 | $10.88 | $19.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.30 / $50.30 / $50.30
| Facility | | $50.30 | $50.30 | $50.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.80 / $17.69 / $54.36
| Facility | | $7.80 | $17.69 | $54.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $6.82 / $22.81
| Professional | | $4.94 | $6.82 | $22.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.81 / $60.00 / $60.00
| Facility | | $28.81 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $12.09 / $19.85
| Professional | | $10.74 | $12.09 | $19.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.07 / $12.09 / $13.30
| Facility | | $9.07 | $12.09 | $13.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $12.09 / $61.00
| Professional | | $10.28 | $12.09 | $61.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.44 / $12.09 / $16.80
| Facility | | $8.44 | $12.09 | $16.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $11.31 / $12.75
| Professional | | $6.20 | $11.31 | $12.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.34 / $5.08 / $12.09
| Facility | | $4.34 | $5.08 | $12.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $7.35
| Professional | | $5.08 | $5.08 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.72 / $4.84 / $12.09
| Professional | | $4.72 | $4.84 | $12.09 |