- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $15.30 / $29.82
| Facility | | $13.73 | $15.30 | $29.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.68 / $15.30 / $29.82
| Professional | | $13.68 | $15.30 | $29.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.45 / $21.70 / $41.58
| Professional | | $16.45 | $21.70 | $41.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.43 / $26.27 / $26.27
| Facility | | $24.43 | $26.27 | $26.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.27 / $26.27 / $26.27
| Professional | | $26.27 | $26.27 | $26.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.95 / $18.95 / $18.95
| Facility | | $18.95 | $18.95 | $18.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $16.11 / $23.40
| Professional | | $16.11 | $16.11 | $23.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.53 / $70.94 / $332.00
| Facility | | $31.53 | $70.94 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.60 / $25.72 / $56.75
| Professional | | $18.60 | $25.72 | $56.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.58 / $22.81 / $26.27
| Professional | | $22.58 | $22.81 | $26.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.95 / $18.95 / $555.00
| Facility | | $18.95 | $18.95 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.11 / $18.95 / $45.47
| Professional | | $16.11 | $18.95 | $45.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $15.73 / $28.91
| Professional | | $10.49 | $15.73 | $28.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.58 / $22.81 / $22.81
| Facility | | $22.58 | $22.81 | $22.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.81 / $22.81 / $22.81
| Professional | | $22.81 | $22.81 | $22.81 |