- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.89 / $11.92 / $13.94
| Facility | | $9.89 | $11.92 | $13.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $13.66 / $25.34
| Professional | | $8.94 | $13.66 | $25.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.44 / $13.83 / $36.43
| Facility | | $11.44 | $13.83 | $36.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.04 / $15.95 / $30.81
| Professional | | $12.04 | $15.95 | $30.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.73 / $31.13 / $39.36
| Facility | | $19.73 | $31.13 | $39.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $17.98 / $28.22
| Professional | | $13.45 | $17.98 | $28.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $12.80 / $12.80
| Professional | | $12.80 | $12.80 | $12.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $15.17 / $34.36
| Professional | | $13.45 | $15.17 | $34.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $75.00 / $75.00
| Facility | | $31.62 | $75.00 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.80 / $146.80 / $148.97
| Professional | | $146.80 | $146.80 | $148.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $60.00
| Professional | | $50.00 | $50.00 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.89 / $15.26 / $24.16
| Facility | | $9.89 | $15.26 | $24.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $12.80 / $31.71
| Professional | | $12.80 | $12.80 | $31.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $18.73 / $42.09
| Professional | | $15.00 | $18.73 | $42.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $21.39 / $79.20
| Professional | | $12.80 | $21.39 | $79.20 |