- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $34.67 / $58.88
| Facility | | $12.59 | $34.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.00 / $23.99
| Professional | | $8.91 | $10.00 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $77.62 / $5,011.87
| Facility | | $58.88 | $77.62 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.96
| Professional | | $10.47 | $10.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $20.42 / $45.71
| Facility | | $8.91 | $20.42 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $15.14 / $21.38
| Professional | | $7.24 | $15.14 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $13.49 / $19.50
| Professional | | $6.31 | $13.49 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $13.49
| Facility | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $13.49 / $23.44
| Professional | | $11.48 | $13.49 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $33.88 / $58.88
| Facility | | $12.59 | $33.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $47.86
| Professional | | $8.91 | $12.02 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $10.96 / $30.20
| Facility | | $6.76 | $10.96 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $13.49 / $30.20
| Professional | | $6.76 | $13.49 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $13.49 / $16.22
| Facility | | $7.94 | $13.49 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $8.91 / $19.95
| Professional | | $6.03 | $8.91 | $19.95 |