- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $16.48 / $25.21
| Professional | | $8.06 | $16.48 | $25.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.13 / $21.13 / $33.71
| Professional | | $21.13 | $21.13 | $33.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.39 / $18.07 / $24.10
| Facility | | $2.39 | $18.07 | $24.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $18.07 / $24.10
| Professional | | $2.39 | $18.07 | $24.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.30 / $17.30 / $17.30
| Facility | | $17.30 | $17.30 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.71 / $17.30 / $30.75
| Professional | | $14.71 | $17.30 | $30.75 |
- 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
- $15.00 / $16.78 / $25.43
| Professional | | $15.00 | $16.78 | $25.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.19 / $18.26 / $21.27
| Professional | | $17.19 | $18.26 | $21.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.30 / $17.30 / $17.30
| Facility | | $17.30 | $17.30 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.71 / $15.30 / $30.75
| Professional | | $14.71 | $15.30 | $30.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $15.38 / $21.25
| Professional | | $8.75 | $15.38 | $21.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.19 / $17.19 / $17.19
| Facility | | $17.19 | $17.19 | $17.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.19 / $17.19 / $21.27
| Professional | | $17.19 | $17.19 | $21.27 |