- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.61 / $22.32 / $381.07
| Facility | | $10.61 | $22.32 | $381.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $10.61 / $13.50
| Professional | | $9.64 | $10.61 | $13.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.60 / $14.84 / $1,252.36
| Facility | | $10.60 | $14.84 | $1,252.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $13.65 / $24.61
| Professional | | $10.60 | $13.65 | $24.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.10 / $9.10 / $27.76
| Facility | | $9.10 | $9.10 | $27.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $9.64 / $11.83
| Professional | | $9.64 | $9.64 | $11.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.64 / $12.05 / $28.92
| Facility | | $9.64 | $12.05 | $28.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.84 / $20.43 / $20.43
| Facility | | $14.84 | $20.43 | $20.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.34 / $13.65 / $24.61
| Professional | | $12.34 | $13.65 | $24.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.60 / $10.60 / $10.60
| Facility | | $10.60 | $10.60 | $10.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $10.60 / $10.60
| Professional | | $10.60 | $10.60 | $10.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $9.64 / $12.34
| Professional | | $9.64 | $9.64 | $12.34 |