- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $7.94
| Facility | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.94 / $8.91
| Professional | | $5.01 | $7.94 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $23.44 / $23.44
| Facility | | $12.88 | $23.44 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $12.88 / $17.38
| Professional | | $10.96 | $12.88 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $51.29
| Facility | | $7.94 | $7.94 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $15.49 / $24.55
| Professional | | $7.94 | $15.49 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $8.71 / $15.49
| Facility | | $3.63 | $8.71 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $7.76
| Professional | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $13.49 / $79.43
| Facility | | $3.63 | $13.49 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $6.76 / $12.30
| Professional | | $5.25 | $6.76 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $50.12 / $89.13
| Professional | | $4.57 | $50.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $3.09 / $4.27
| Professional | | $1.70 | $3.09 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $25.12 / $79.43
| Facility | | $7.94 | $25.12 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $7.94 / $9.33
| Professional | | $6.76 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.60 / $5.13 / $8.71
| Facility | | $0.60 | $5.13 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $6.61 / $13.80
| Professional | | $4.47 | $6.61 | $13.80 |