- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $8.99 / $15.83
| Professional | | $7.25 | $8.99 | $15.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.25 / $13.25 / $20.82
| Professional | | $13.25 | $13.25 | $20.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $12.42 / $16.57
| Facility | | $1.69 | $12.42 | $16.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $12.42 / $16.57
| Professional | | $1.69 | $12.42 | $16.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.87 / $10.87 / $14.27
| Facility | | $10.87 | $10.87 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $10.87 / $17.82
| Professional | | $9.24 | $10.87 | $17.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $332.00 / $332.00
| Facility | | $319.00 | $332.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.98 / $11.62 / $14.49
| Professional | | $8.98 | $11.62 | $14.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.18 / $16.45 / $17.32
| Professional | | $15.18 | $16.45 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.91 / $11.91 / $11.91
| Professional | | $11.91 | $11.91 | $11.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.87 / $10.87 / $14.27
| Facility | | $10.87 | $10.87 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $10.87 / $17.82
| Professional | | $1.81 | $10.87 | $17.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $9.91 / $15.94
| Professional | | $5.44 | $9.91 | $15.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.48 / $15.48 / $15.48
| Facility | | $15.48 | $15.48 | $15.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.48 / $15.48 / $17.32
| Professional | | $15.48 | $15.48 | $17.32 |