- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.23 / $10.83 / $13.43
| Facility | | $8.23 | $10.83 | $13.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.90 / $10.83 / $14.43
| Professional | | $6.90 | $10.83 | $14.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.34 / $18.51 / $45.24
| Facility | | $12.34 | $18.51 | $45.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $7.85 / $7.85
| Professional | | $7.85 | $7.85 | $7.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.94 / $11.94 / $11.94
| Facility | | $11.94 | $11.94 | $11.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.90 / $9.90 / $19.32
| Facility | | $9.90 | $9.90 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.42 / $8.42
| Professional | | $8.42 | $8.42 | $8.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.01 / $80.00 / $85.00
| Facility | | $33.01 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.94 / $112.59 / $112.59
| Professional | | $109.94 | $112.59 | $112.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $12.91 / $20.57
| Facility | | $10.83 | $12.91 | $20.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $14.03 / $16.50
| Professional | | $12.63 | $14.03 | $16.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.70 / $20.30 / $32.20
| Professional | | $6.70 | $20.30 | $32.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $12.98 / $21.06
| Facility | | $10.83 | $12.98 | $21.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.42 / $12.84
| Professional | | $8.42 | $8.42 | $12.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.83 / $7.61 / $10.02
| Professional | | $5.83 | $7.61 | $10.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $16.50 / $22.28
| Professional | | $7.43 | $16.50 | $22.28 |