- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $6.70 / $44.28
| Facility | | $6.70 | $6.70 | $44.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.70 / $7.79 / $44.28
| Professional | | $6.70 | $7.79 | $44.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.19 / $17.98 / $46.50
| Facility | | $8.19 | $17.98 | $46.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.58 / $13.81
| Professional | | $10.57 | $10.58 | $13.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.27 / $27.37 / $36.18
| Facility | | $19.27 | $27.37 | $36.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.99 / $15.70 / $25.91
| Professional | | $10.99 | $15.70 | $25.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.57 / $14.57 / $14.57
| Professional | | $14.57 | $14.57 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.83 / $13.83 / $15.21
| Professional | | $13.83 | $13.83 | $15.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $17.87 / $41.10
| Professional | | $14.00 | $17.87 | $41.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.90 / $85.00 / $85.00
| Facility | | $26.90 | $85.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $12.24 / $21.50
| Facility | | $9.60 | $12.24 | $21.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $13.83 / $14.57
| Professional | | $8.24 | $13.83 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.96 / $28.96 / $28.96
| Professional | | $28.96 | $28.96 | $28.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.06 / $16.07 / $27.32
| Professional | | $11.06 | $16.07 | $27.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.17 / $17.46 / $40.77
| Professional | | $8.17 | $17.46 | $40.77 |