- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $16.98 / $63.10
| Facility | | $10.96 | $16.98 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $16.98 / $41.69
| Professional | | $10.72 | $16.98 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $18.20 / $30.90 / $53.70
| Professional | 25 | $18.20 | $30.90 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $57.54 / $154.88
| Facility | | $9.33 | $57.54 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $29.51 / $43.65
| Professional | | $18.20 | $29.51 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $14.13 / $22.91 / $34.67
| Professional | 25 | $14.13 | $22.91 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $45.71 / $128.82
| Facility | | $25.70 | $45.71 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $28.18 / $50.12
| Professional | | $14.13 | $28.18 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $50.12 / $102.33
| Facility | | $33.88 | $50.12 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $31.62 / $47.86
| Professional | | $19.95 | $31.62 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $17.38 / $33.88
| Facility | | $10.96 | $17.38 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $28.84 / $64.57
| Professional | | $13.49 | $28.84 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $25.12 / $53.70 / $58.88
| Professional | 25 | $25.12 | $53.70 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $97.72
| Facility | | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $21.38 / $38.90
| Professional | | $12.30 | $21.38 | $38.90 |