- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $9.33 / $9.33
| Facility | | $8.91 | $9.33 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $13.49
| Professional | | $8.91 | $8.91 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $9.77 / $23.99
| Professional | | $7.41 | $9.77 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $6.17 / $10.00
| Facility | | $2.95 | $6.17 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $3.89 / $10.00
| Professional | | $2.24 | $3.89 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $15.85
| Facility | | $2.75 | $2.75 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $4.17
| Professional | | $2.69 | $2.69 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $15.85
| Facility | | $2.75 | $2.75 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $12.88
| Professional | | $9.77 | $9.77 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $17.38 / $25.70
| Professional | | $9.55 | $17.38 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $100.00
| Facility | | $10.00 | $10.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $13.49
| Professional | | $3.72 | $3.72 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $7.08
| Facility | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $13.49
| Professional | | $9.77 | $9.77 | $13.49 |