- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $15.14 / $24.55
| Facility | | $12.88 | $15.14 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $15.14 / $39.81
| Professional | | $10.23 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $25.12 / $44.67 / $44.67
| Professional | 25 | $25.12 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $19.95 / $81.28
| Facility | | $9.55 | $19.95 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $18.62 / $39.81
| Professional | | $12.30 | $18.62 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $33.11
| Facility | | $14.45 | $14.45 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $25.12 / $35.48
| Professional | | $14.45 | $25.12 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $19.50 / $34.67
| Professional | | $14.13 | $19.50 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $14.45
| Facility | | $11.22 | $11.22 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $17.38 / $30.90
| Professional | | $8.91 | $17.38 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $22.91 / $38.90
| Professional | | $13.18 | $22.91 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $22.91 / $28.18
| Professional | | $16.60 | $22.91 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $19.95 / $81.28
| Facility | | $9.55 | $19.95 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $18.62 / $39.81
| Professional | | $12.59 | $18.62 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $18.62 / $37.15
| Professional | | $12.30 | $18.62 | $37.15 |