- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.66 / $9.36 / $15.99
| Facility | | $6.66 | $9.36 | $15.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.66 / $9.36 / $14.45
| Professional | | $6.66 | $9.36 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.78 / $6.78 / $24.53
| Professional | | $6.78 | $6.78 | $24.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.84 / $12.73 / $12.73
| Facility | | $11.84 | $12.73 | $12.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.73 / $12.73 / $12.73
| Professional | | $12.73 | $12.73 | $12.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $17.89
| Facility | | $17.89 | $17.89 | $17.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $7.80 / $7.80
| Professional | | $7.80 | $7.80 | $7.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.28 / $27.96 / $332.00
| Facility | | $15.28 | $27.96 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.28 / $20.63 / $33.15
| Professional | | $15.28 | $20.63 | $33.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.48 / $2.48 / $8.84
| Facility | | $2.48 | $2.48 | $8.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $8.84 / $9.39
| Professional | | $2.48 | $8.84 | $9.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $597.00
| Facility | | $17.89 | $17.89 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $7.80 / $26.16
| Professional | | $7.80 | $7.80 | $26.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $8.65 / $16.51
| Professional | | $5.08 | $8.65 | $16.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.84 / $8.84 / $10.94
| Facility | | $8.84 | $8.84 | $10.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $8.84 / $9.39
| Professional | | $2.48 | $8.84 | $9.39 |