- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $12.76 / $59.72
| Professional | | $5.78 | $12.76 | $59.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $12.44
| Facility | | $12.44 | $12.44 | $12.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.57 / $16.09
| Professional | | $10.57 | $10.57 | $16.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $36.92 / $45.14
| Professional | | $10.56 | $36.92 | $45.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $15.43 / $19.36
| Facility | | $12.61 | $15.43 | $19.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.97 / $15.84 / $18.48
| Professional | | $12.97 | $15.84 | $18.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.98 / $17.60 / $20.70
| Facility | | $13.98 | $17.60 | $20.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.39 / $17.60 / $20.70
| Professional | | $15.39 | $17.60 | $20.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $15.40 / $18.12
| Facility | | $12.44 | $15.40 | $18.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $15.40 / $20.62
| Professional | | $10.57 | $15.40 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.75 / $19.36 / $19.36
| Professional | | $16.75 | $19.36 | $19.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $8.77 / $16.75
| Professional | | $8.27 | $8.77 | $16.75 |