- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $22.48 / $65.61
| Facility | | $9.50 | $22.48 | $65.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.18 / $14.82
| Professional | | $12.06 | $12.18 | $14.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.66 / $11.79 / $23.30
| Facility | | $4.66 | $11.79 | $23.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.33 / $5.33 / $5.33
| Professional | | $5.33 | $5.33 | $5.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $10.79 / $21.38
| Facility | | $4.51 | $10.79 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.66 / $537.66 / $537.66
| Facility | | $537.66 | $537.66 | $537.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $12.05 / $12.05
| Facility | | $11.37 | $12.05 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $12.05
| Professional | | $12.05 | $12.05 | $12.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $85.00 / $100.00
| Facility | | $75.00 | $85.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.79 / $17.25 / $26.32
| Facility | | $10.79 | $17.25 | $26.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $12.06 / $21.69
| Professional | | $8.09 | $12.06 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $12.05 / $17.76
| Facility | | $11.37 | $12.05 | $17.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.31 / $12.05 / $20.91
| Professional | | $11.31 | $12.05 | $20.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.20 / $16.20 / $16.20
| Facility | | $16.20 | $16.20 | $16.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $12.06
| Professional | | $12.06 | $12.06 | $12.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.79 / $11.55 / $16.28
| Professional | | $10.79 | $11.55 | $16.28 |