- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $16.77 / $19.03
| Facility | | $12.92 | $16.77 | $19.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.92 / $17.00 / $22.66
| Professional | | $12.92 | $17.00 | $22.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.78 / $29.27 / $72.98
| Facility | | $14.78 | $29.27 | $72.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $12.32 / $12.32
| Professional | | $12.32 | $12.32 | $12.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.88 / $25.88 / $25.88
| Facility | | $25.88 | $25.88 | $25.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.54 / $15.54 / $16.01
| Facility | | $15.54 | $15.54 | $16.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.21 / $15.54
| Professional | | $10.56 | $13.21 | $15.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.09 / $122.93 / $122.93
| Facility | | $117.09 | $122.93 | $122.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.22 / $167.13 / $194.10
| Professional | | $163.22 | $167.13 | $194.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $19.03 / $25.88
| Facility | | $7.08 | $19.03 | $25.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $22.00 / $25.88
| Professional | | $8.74 | $22.00 | $25.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $18.52 / $25.88
| Facility | | $7.08 | $18.52 | $25.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.21 / $18.29
| Professional | | $10.56 | $13.21 | $18.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $10.15 / $16.32
| Facility | | $8.71 | $10.15 | $16.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.15 / $11.94 / $15.74
| Professional | | $9.15 | $11.94 | $15.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.11 / $11.11 / $25.88
| Professional | | $11.11 | $11.11 | $25.88 |