- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.97 / $11.65 / $13.22
| Facility | | $8.97 | $11.65 | $13.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.61 / $11.81 / $17.73
| Professional | | $8.61 | $11.81 | $17.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.49 / $19.88 / $50.23
| Facility | | $11.49 | $19.88 | $50.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $8.56 / $9.60
| Professional | | $8.56 | $8.56 | $9.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.78 / $15.27 / $17.97
| Professional | | $10.78 | $15.27 | $17.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.97 / $17.97 / $17.97
| Facility | | $17.97 | $17.97 | $17.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $12.44 / $12.44
| Facility | | $8.94 | $12.44 | $12.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.57 / $12.44
| Professional | | $10.57 | $10.57 | $12.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.20 / $98.33 / $98.33
| Facility | | $92.20 | $98.33 | $98.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.00 / $115.70 / $141.83
| Professional | | $113.00 | $115.70 | $141.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.67 / $13.51 / $18.34
| Facility | | $5.67 | $13.51 | $18.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $15.27 / $17.97
| Professional | | $7.00 | $15.27 | $17.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.67 / $12.88 / $18.23
| Facility | | $5.67 | $12.88 | $18.23 |
- 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
- $7.32 / $9.56 / $12.61
| Professional | | $7.32 | $9.56 | $12.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $9.35 / $17.97
| Professional | | $9.35 | $9.35 | $17.97 |