- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.22 / $40.56 / $99.64
| Facility | | $10.22 | $40.56 | $99.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $11.49 / $18.55
| Professional | | $8.11 | $11.49 | $18.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.49 / $6.49 / $6.49
| Professional | | $6.49 | $6.49 | $6.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.82 / $43.80 / $80.98
| Facility | | $15.82 | $43.80 | $80.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.17 / $11.80
| Professional | | $5.00 | $7.17 | $11.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $20.96 / $63.23
| Facility | | $13.52 | $20.96 | $63.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $13.52 / $20.41
| Professional | | $10.14 | $13.52 | $20.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $18.93 / $18.93
| Facility | | $13.52 | $18.93 | $18.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.44 / $29.71 / $68.75
| Facility | | $9.44 | $29.71 | $68.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.17 / $9.93 / $22.98
| Professional | | $7.17 | $9.93 | $22.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $81.00 / $81.00
| Facility | | $55.00 | $81.00 | $81.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $13.52 / $20.21
| Facility | | $10.82 | $13.52 | $20.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $13.52 / $17.61
| Professional | | $12.17 | $13.52 | $17.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $13.52 / $32.19
| Facility | | $10.82 | $13.52 | $32.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.17 / $10.41 / $19.52
| Professional | | $7.17 | $10.41 | $19.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.73 / $9.97 / $16.89
| Facility | | $4.73 | $9.97 | $16.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.68 / $7.73 / $11.06
| Professional | | $5.68 | $7.73 | $11.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.27 / $6.68 / $13.52
| Professional | | $5.27 | $6.68 | $13.52 |