- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.95 / $21.16 / $25.57
| Facility | | $10.95 | $21.16 | $25.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $11.06 / $25.57
| Professional | | $10.94 | $11.06 | $25.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.14 / $17.48 / $41.26
| Facility | | $11.14 | $17.48 | $41.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $10.95 / $26.14
| Professional | | $10.58 | $10.95 | $26.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.14 / $11.52 / $24.14
| Facility | | $11.14 | $11.52 | $24.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.16 / $11.16 / $29.80
| Professional | | $11.16 | $11.16 | $29.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.33 / $10.33 / $10.95
| Facility | | $10.33 | $10.33 | $10.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $10.95 / $10.95
| Professional | | $10.95 | $10.95 | $10.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $13.14 / $24.81
| Professional | | $9.86 | $13.14 | $24.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $85.00 / $85.00
| Facility | | $75.00 | $85.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.33 / $10.95 / $15.61
| Facility | | $10.33 | $10.95 | $15.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $10.95 / $23.68
| Professional | | $10.95 | $10.95 | $23.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.36 / $17.36 / $17.36
| Professional | | $17.36 | $17.36 | $17.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.76 / $12.05 / $18.62
| Professional | | $8.76 | $12.05 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.64 / $31.24 / $31.24
| Facility | | $29.64 | $31.24 | $31.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $10.95 / $22.51
| Professional | | $10.95 | $10.95 | $22.51 |