- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.81 / $16.63 / $18.87
| Facility | | $12.81 | $16.63 | $18.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.50 / $16.85 / $22.47
| Professional | | $12.50 | $16.85 | $22.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.50 / $20.67 / $74.41
| Facility | | $13.50 | $20.67 | $74.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.21 / $12.21 / $13.71
| Professional | | $12.21 | $12.21 | $13.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.65 / $25.65 / $25.65
| Facility | | $25.65 | $25.65 | $25.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.42 / $15.42 / $17.39
| Facility | | $15.42 | $15.42 | $17.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $13.11 / $18.14
| Professional | | $13.11 | $13.11 | $18.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $116.25 / $121.84
| Facility | | $85.00 | $116.25 | $121.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.74 / $169.70 / $169.70
| Professional | | $165.74 | $169.70 | $169.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.02 / $19.27 / $25.65
| Facility | | $7.02 | $19.27 | $25.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.70 / $23.09 / $25.65
| Professional | | $15.70 | $23.09 | $25.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.02 / $18.37 / $25.65
| Facility | | $7.02 | $18.37 | $25.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $13.11 / $20.22
| Professional | | $13.11 | $13.11 | $20.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $11.74 / $15.61
| Professional | | $9.07 | $11.74 | $15.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $10.93 / $25.65
| Professional | | $10.93 | $10.93 | $25.65 |