- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.28 / $27.62 / $86.73
| Facility | | $13.28 | $27.62 | $86.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $13.28 / $30.88
| Professional | | $10.84 | $13.28 | $30.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.84 / $28.26 / $80.54
| Facility | | $14.84 | $28.26 | $80.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $10.85 / $22.65
| Professional | | $5.92 | $10.85 | $22.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $21.74 / $38.47
| Facility | | $8.30 | $21.74 | $38.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $16.52 / $23.86
| Professional | | $8.26 | $16.52 | $23.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $13.63 / $14.99
| Professional | | $10.06 | $13.63 | $14.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $14.13 / $31.19
| Facility | | $14.13 | $14.13 | $31.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $14.13 / $27.74
| Facility | | $12.72 | $14.13 | $27.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.72 / $12.72 / $12.72
| Professional | | $12.72 | $12.72 | $12.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.25 / $23.19 / $38.86
| Facility | | $16.25 | $23.19 | $38.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $14.13 / $37.72
| Professional | | $10.60 | $14.13 | $37.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.93 / $5.93 / $14.13
| Professional | | $5.93 | $5.93 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.32 / $7.32 / $7.32
| Professional | | $7.32 | $7.32 | $7.32 |