- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.15 / $8.15 / $12.94
| Facility | | $8.15 | $8.15 | $12.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $10.19 / $12.94
| Professional | | $5.78 | $10.19 | $12.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $16.63 / $16.63
| Professional | | $12.66 | $16.63 | $16.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.99 / $9.99 / $17.72
| Facility | | $9.99 | $9.99 | $17.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.49 / $8.49 / $12.34
| Professional | | $8.49 | $8.49 | $12.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $14.14 / $26.87
| Professional | | $13.01 | $14.14 | $26.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.15 / $8.15 / $12.94
| Facility | | $8.15 | $8.15 | $12.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $10.19 / $13.75
| Professional | | $5.78 | $10.19 | $13.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $22.70 / $32.79
| Professional | | $12.40 | $22.70 | $32.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.99 / $9.99 / $17.72
| Facility | | $9.99 | $9.99 | $17.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.49 / $8.49 / $18.38
| Professional | | $8.49 | $8.49 | $18.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.88 / $15.83 / $15.83
| Facility | | $11.88 | $15.83 | $15.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.88 / $15.83 / $15.83
| Professional | | $11.88 | $15.83 | $15.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.83 / $8.32 / $14.98
| Professional | | $5.83 | $8.32 | $14.98 |