- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $1.56 / $29.27
| Facility | | $0.71 | $1.56 | $29.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $0.72 / $2.90
| Professional | | $0.71 | $0.72 | $2.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $0.82 / $1.02
| Facility | | $0.71 | $0.82 | $1.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $0.79 / $3.56
| Professional | | $0.71 | $0.79 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.38 / $2.54 / $4.20
| Facility | | $2.38 | $2.54 | $4.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.72 / $0.72 / $1.21
| Professional | | $0.72 | $0.72 | $1.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.67 / $0.67 / $2.38
| Facility | | $0.67 | $0.67 | $2.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $0.71 / $2.54
| Professional | | $0.71 | $0.71 | $2.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.65 / $0.73 / $0.86
| Professional | | $0.65 | $0.73 | $0.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.64 / $0.82 / $1.90
| Professional | | $0.64 | $0.82 | $1.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.67 / $0.71 / $1.03
| Facility | | $0.67 | $0.71 | $1.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $0.74 / $2.80
| Professional | | $0.71 | $0.74 | $2.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.88 / $19.88 / $19.88
| Professional | | $19.88 | $19.88 | $19.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.56 / $0.78 / $1.21
| Professional | | $0.56 | $0.78 | $1.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $0.71 / $1.95
| Professional | | $0.71 | $0.71 | $1.95 |