- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.88 / $13.92 / $23.77
| Facility | | $9.88 | $13.92 | $23.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.88 / $13.92 / $21.47
| Professional | | $9.88 | $13.92 | $21.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.97 / $13.36 / $34.14
| Professional | | $10.97 | $13.36 | $34.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.60 / $18.92 / $18.92
| Facility | | $17.60 | $18.92 | $18.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.92 / $18.92 / $18.92
| Professional | | $18.92 | $18.92 | $18.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.60 / $26.60 / $26.60
| Facility | | $26.60 | $26.60 | $26.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.59 / $11.59 / $11.59
| Professional | | $11.59 | $11.59 | $11.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.70 / $41.54 / $332.00
| Facility | | $22.70 | $41.54 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $30.65 / $49.26
| Professional | | $13.12 | $30.65 | $49.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.20 / $4.20 / $13.12
| Facility | | $4.20 | $4.20 | $13.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $13.12 / $13.94
| Professional | | $4.20 | $13.12 | $13.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.60 / $26.60 / $597.00
| Facility | | $26.60 | $26.60 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.59 / $11.59 / $38.89
| Professional | | $11.59 | $11.59 | $38.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $12.99 / $25.07
| Professional | | $7.55 | $12.99 | $25.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $13.12 / $16.23
| Facility | | $13.12 | $13.12 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $13.12 / $13.94
| Professional | | $4.20 | $13.12 | $13.94 |