- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $26.30 / $45.71
| Facility | | $10.96 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $7.94 / $19.05
| Professional | | $6.03 | $7.94 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.66 / $56.23 / $5,011.87
| Facility | | $42.66 | $56.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $15.85 / $35.48
| Facility | | $6.92 | $15.85 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $10.00 / $15.49
| Professional | | $4.90 | $10.00 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $6.17 / $15.14
| Professional | | $4.90 | $6.17 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Facility | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.47 / $18.20
| Professional | | $8.32 | $10.47 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $28.18
| Facility | | $28.18 | $28.18 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $25.70 / $45.71
| Facility | | $10.96 | $25.70 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $8.91 / $35.48
| Professional | | $7.08 | $8.91 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $10.47
| Facility | | $9.77 | $9.77 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $9.77 / $16.22
| Professional | | $6.92 | $9.77 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $10.47 / $12.59
| Facility | | $5.50 | $10.47 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $6.17 / $15.49
| Professional | | $4.37 | $6.17 | $15.49 |