- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $11.75 / $11.75
| Facility | | $10.96 | $11.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $17.78
| Professional | | $8.91 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $22.39 / $39.81
| Professional | | $11.48 | $22.39 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $19.05 / $33.11
| Facility | | $8.91 | $19.05 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $11.75 / $21.88
| Professional | | $9.33 | $11.75 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $12.59 / $23.99
| Facility | | $10.47 | $12.59 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $7.76
| Professional | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $12.59 / $23.99
| Facility | | $10.47 | $12.59 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $15.49 / $19.95
| Professional | | $15.49 | $15.49 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $54.95 / $85.11
| Professional | | $50.12 | $54.95 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $26.92 / $37.15
| Professional | | $17.78 | $26.92 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $100.00
| Facility | | $8.91 | $8.91 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $8.91
| Professional | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $38.02
| Professional | | $20.42 | $20.42 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $10.96 / $10.96
| Facility | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $15.49 / $20.89
| Professional | | $15.49 | $15.49 | $20.89 |