- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $10.02 / $10.02
| Facility | | $10.02 | $10.02 | $10.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.97 / $12.97 / $16.64
| Professional | | $7.97 | $12.97 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.61 / $21.18 / $64.88
| Professional | | $3.61 | $21.18 | $64.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.86 / $54.76 / $84.00
| Facility | | $46.86 | $54.76 | $84.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $14.02 / $35.21
| Professional | | $13.49 | $14.02 | $35.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.21 / $13.59 / $23.99
| Facility | | $9.21 | $13.59 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.84 / $14.00 / $32.85
| Facility | | $9.84 | $14.00 | $32.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.71 / $11.05 / $134.28
| Professional | | $9.71 | $11.05 | $134.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $60.48 / $70.00
| Professional | | $50.00 | $60.48 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $13.59 / $28.00
| Facility | | $10.02 | $13.59 | $28.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.57 / $38.93 / $55.17
| Professional | | $21.57 | $38.93 | $55.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.57 / $44.61 / $90.29
| Facility | | $21.57 | $44.61 | $90.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $73.13 / $134.28
| Professional | | $13.49 | $73.13 | $134.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.78 / $26.78 / $31.50
| Professional | | $26.78 | $26.78 | $31.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.99 / $10.48 / $18.85
| Professional | | $6.99 | $10.48 | $18.85 |