- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $21.99
| Facility | | $9.86 | $9.86 | $21.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $14.83
| Professional | | $9.86 | $9.86 | $14.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $8.91 / $10.27
| Professional | | $2.38 | $8.91 | $10.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.99 / $1.80 / $10.48
| Facility | | $0.99 | $1.80 | $10.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.77 / $3.91 / $4.44
| Professional | | $0.77 | $3.91 | $4.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.08 / $2.60 / $12.33
| Facility | | $0.08 | $2.60 | $12.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.34 / $1.34 / $1.34
| Professional | | $1.34 | $1.34 | $1.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.08 / $2.60 / $12.33
| Facility | | $0.08 | $2.60 | $12.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $13.35
| Professional | | $10.27 | $10.27 | $13.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.76 / $55.00 / $85.00
| Professional | | $24.76 | $55.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.08 / $2.60 / $12.33
| Facility | | $0.08 | $2.60 | $12.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.34 / $1.34 / $1.34
| Professional | | $1.34 | $1.34 | $1.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $5.34 / $7.70
| Professional | | $2.52 | $5.34 | $7.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $10.48 / $10.48
| Professional | | $10.48 | $10.48 | $10.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.19 / $5.30 / $7.65
| Professional | | $4.19 | $5.30 | $7.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $12.94
| Professional | | $10.27 | $10.27 | $12.94 |