- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.28 / $3.66 / $9.48
| Facility | | $0.28 | $3.66 | $9.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.19 / $0.20 / $0.31
| Professional | | $0.19 | $0.20 | $0.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $15.00 / $15.00
| Professional | | $15.00 | $15.00 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.31 / $0.39 / $1.21
| Facility | | $0.31 | $0.39 | $1.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.31 / $0.31 / $0.31
| Professional | | $0.31 | $0.31 | $0.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.20 / $0.33 / $1.12
| Facility | | $0.20 | $0.33 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.17 / $0.17 / $0.17
| Facility | | $0.17 | $0.17 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.18 / $0.20 / $0.20
| Facility | | $0.18 | $0.20 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.20 / $0.20 / $0.41
| Professional | | $0.20 | $0.20 | $0.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.20 / $0.20 / $4.63
| Facility | | $0.20 | $0.20 | $4.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.19 / $0.20 / $0.44
| Professional | | $0.19 | $0.20 | $0.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.18 / $0.20 / $0.40
| Facility | | $0.18 | $0.20 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.20 / $0.20 / $0.41
| Professional | | $0.20 | $0.20 | $0.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.15 / $0.20 / $0.20
| Professional | | $0.15 | $0.20 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.19 / $0.19 / $0.27
| Professional | | $0.19 | $0.19 | $0.27 |