- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $28.18 / $234.42
| Facility | | $15.14 | $28.18 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.96 / $21.88
| Professional | | $7.94 | $10.96 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $32.36 / $43.65
| Facility | | $19.95 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $12.30 / $21.88
| Professional | | $8.13 | $12.30 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $26.92 / $31.62
| Professional | | $12.30 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $23.99
| Facility | | $12.30 | $12.30 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $15.14 / $20.89
| Professional | | $12.30 | $15.14 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $23.44
| Facility | | $12.30 | $12.30 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $17.78 / $40.74
| Facility | | $11.75 | $17.78 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $15.14 / $79.43
| Professional | | $12.30 | $15.14 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $37.15 / $50.12
| Facility | | $18.20 | $37.15 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $12.30 / $15.49
| Professional | | $9.12 | $12.30 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $14.79 / $19.50
| Facility | | $14.79 | $14.79 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $7.08 / $16.98
| Professional | | $5.13 | $7.08 | $16.98 |