- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.59 / $20.59 / $20.59
| Facility | | $20.59 | $20.59 | $20.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.65 / $19.48 / $23.48
| Professional | | $7.65 | $19.48 | $23.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $21.51 / $50.94
| Professional | | $7.83 | $21.51 | $50.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.88 / $75.81 / $116.31
| Facility | | $64.88 | $75.81 | $116.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.38 / $34.77 / $50.29
| Professional | | $27.38 | $34.77 | $50.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.93 / $20.82 / $27.87
| Facility | | $10.93 | $20.82 | $27.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.92 / $20.65 / $28.72
| Facility | | $10.92 | $20.65 | $28.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.07 / $36.65 / $123.60
| Professional | | $13.07 | $36.65 | $123.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.71 / $30.95 / $65.00
| Professional | | $19.71 | $30.95 | $65.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.93 / $20.82 / $27.87
| Facility | | $10.93 | $20.82 | $27.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.90 / $41.28 / $72.00
| Professional | | $25.90 | $41.28 | $72.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.82 / $44.82 / $44.82
| Facility | | $44.82 | $44.82 | $44.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.76 / $100.85 / $123.60
| Professional | | $43.76 | $100.85 | $123.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.51 / $15.51 / $15.51
| Professional | | $15.51 | $15.51 | $15.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.51 / $63.72 / $63.72
| Professional | | $15.51 | $63.72 | $63.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.07 / $29.96 / $58.86
| Professional | | $13.07 | $29.96 | $58.86 |