- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.12 / $16.70 / $20.32
| Facility | | $12.12 | $16.70 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.72 / $19.73 / $25.71
| Professional | | $12.72 | $19.73 | $25.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $12.23 / $36.65
| Professional | | $9.35 | $12.23 | $36.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.95 / $21.95 / $21.95
| Facility | | $21.95 | $21.95 | $21.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.95 / $21.95 / $23.86
| Professional | | $21.95 | $21.95 | $23.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.25 / $20.25 / $20.25
| Facility | | $20.25 | $20.25 | $20.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.18 / $15.18 / $15.18
| Professional | | $15.18 | $15.18 | $15.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.00 / $23.86 / $332.00
| Facility | | $8.00 | $23.86 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.80 / $23.09 / $34.72
| Professional | | $17.80 | $23.09 | $34.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.18 / $16.00 / $22.40
| Facility | | $15.18 | $16.00 | $22.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.83 / $21.44 / $35.60
| Professional | | $12.83 | $21.44 | $35.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.25 / $20.25 / $20.25
| Facility | | $20.25 | $20.25 | $20.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.18 / $17.66 / $36.93
| Professional | | $15.18 | $17.66 | $36.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.25 / $18.82 / $41.98
| Professional | | $13.25 | $18.82 | $41.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $16.70 / $22.40
| Facility | | $16.00 | $16.70 | $22.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.86 / $20.86 / $39.79
| Professional | | $14.86 | $20.86 | $39.79 |