- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $22.33 / $44.72
| Facility | | $11.26 | $22.33 | $44.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.51 / $17.87 / $30.71
| Professional | | $10.51 | $17.87 | $30.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.18 / $21.57 / $39.34
| Professional | | $16.18 | $21.57 | $39.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.03 / $18.03 / $18.03
| Facility | | $18.03 | $18.03 | $18.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.03 / $18.03 / $36.17
| Professional | | $18.03 | $18.03 | $36.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $16.57
| Facility | | $16.57 | $16.57 | $16.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $25.23 / $54.57
| Professional | | $12.71 | $25.23 | $54.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.19 / $30.89 / $332.00
| Facility | | $19.19 | $30.89 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.41 / $34.27 / $49.89
| Professional | | $27.41 | $34.27 | $49.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.20 / $22.99 / $29.19
| Facility | | $12.20 | $22.99 | $29.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.37 / $29.19 / $53.08
| Professional | | $20.37 | $29.19 | $53.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $16.57
| Facility | | $16.57 | $16.57 | $16.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.70 / $30.45 / $63.22
| Professional | | $14.70 | $30.45 | $63.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.50 / $28.32 / $56.61
| Professional | | $20.50 | $28.32 | $56.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.97 / $22.99 / $29.19
| Facility | | $11.97 | $22.99 | $29.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.97 / $30.43 / $45.67
| Professional | | $23.97 | $30.43 | $45.67 |