- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.80 / $27.17 / $75.15
| Facility | | $10.80 | $27.17 | $75.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $12.23 / $23.46
| Professional | | $10.80 | $12.23 | $23.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $35.44
| Professional | | $11.75 | $11.75 | $35.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.22 / $20.67 / $20.67
| Facility | | $19.22 | $20.67 | $20.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.67 / $20.67 / $20.67
| Professional | | $20.67 | $20.67 | $20.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.44 / $16.44 / $16.44
| Facility | | $16.44 | $16.44 | $16.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.97 / $13.97 / $19.34
| Professional | | $13.97 | $13.97 | $19.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.80 / $55.80 / $332.00
| Facility | | $24.80 | $55.80 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.81 / $20.25 / $45.38
| Professional | | $12.81 | $20.25 | $45.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.03 / $11.03 / $11.03
| Facility | | $11.03 | $11.03 | $11.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $14.35 / $17.79
| Professional | | $11.03 | $14.35 | $17.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.44 / $16.44 / $555.00
| Facility | | $16.44 | $16.44 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.97 / $16.44 / $36.95
| Professional | | $13.97 | $16.44 | $36.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $13.54 / $22.75
| Professional | | $8.25 | $13.54 | $22.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.35 / $14.35 / $17.76
| Facility | | $14.35 | $14.35 | $17.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $14.35 / $15.25
| Professional | | $11.03 | $14.35 | $15.25 |