- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.66 / $12.62 / $37.88
| Facility | | $8.66 | $12.62 | $37.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.66 / $8.66 / $10.76
| Professional | | $8.66 | $8.66 | $10.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $8.66 / $8.66
| Professional | | $5.69 | $8.66 | $8.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.11 / $6.11 / $6.42
| Facility | | $6.11 | $6.11 | $6.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.11 / $6.11 / $6.11
| Professional | | $6.11 | $6.11 | $6.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $8.17 / $8.66
| Facility | | $6.56 | $8.17 | $8.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.66 / $8.66 / $10.73
| Professional | | $8.66 | $8.66 | $10.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.39 / $14.71 / $332.00
| Facility | | $9.39 | $14.71 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.88 / $9.39 / $10.29
| Professional | | $5.88 | $9.39 | $10.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.66 / $8.66 / $8.98
| Facility | | $8.66 | $8.66 | $8.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.66 / $8.66 / $8.98
| Professional | | $8.66 | $8.66 | $8.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.84 / $13.68 / $17.63
| Facility | | $12.84 | $13.68 | $17.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $8.17 / $17.63
| Facility | | $6.56 | $8.17 | $17.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.15 / $8.66 / $17.18
| Professional | | $8.15 | $8.66 | $17.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $8.66 / $16.13
| Professional | | $3.46 | $8.66 | $16.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.98 / $8.98 / $8.98
| Facility | | $8.98 | $8.98 | $8.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $8.98 / $8.98
| Professional | | $2.45 | $8.98 | $8.98 |