- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.38 / $16.89 / $25.07
| Professional | | $11.38 | $16.89 | $25.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.59 / $19.59 / $32.15
| Professional | | $19.59 | $19.59 | $32.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $14.69 / $25.71
| Facility | | $2.64 | $14.69 | $25.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $14.69 / $25.71
| Professional | | $2.64 | $14.69 | $25.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.88 / $15.88 / $21.26
| Facility | | $15.88 | $15.88 | $21.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.50 / $15.88 / $25.92
| Professional | | $13.50 | $15.88 | $25.92 |
- 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
- $13.71 / $17.42 / $23.23
| Professional | | $13.71 | $17.42 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.29 / $20.62 / $21.92
| Professional | | $16.29 | $20.62 | $21.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.10 / $19.10 / $19.10
| Professional | | $19.10 | $19.10 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.88 / $15.88 / $21.26
| Facility | | $15.88 | $15.88 | $21.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $15.88 / $25.92
| Professional | | $1.89 | $15.88 | $25.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $17.64 / $25.28
| Professional | | $8.69 | $17.64 | $25.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.62 / $20.62 / $20.62
| Facility | | $20.62 | $20.62 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.29 / $20.62 / $21.92
| Professional | | $16.29 | $20.62 | $21.92 |