- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $25.58 / $36.45
| Facility | | $12.11 | $25.58 | $36.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.27 / $12.28 / $14.51
| Professional | | $12.27 | $12.28 | $14.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.38 / $13.33 / $8,459.92
| Facility | | $11.38 | $13.33 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.75 / $12.75 / $12.75
| Professional | | $12.75 | $12.75 | $12.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.59 / $12.28 / $12.28
| Facility | | $11.59 | $12.28 | $12.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $12.28 / $12.75
| Professional | | $12.28 | $12.28 | $12.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.75 / $13.33 / $17.21
| Professional | | $12.75 | $13.33 | $17.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.69 / $56.69 / $56.69
| Facility | | $56.69 | $56.69 | $56.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $20.47 / $36.45
| Facility | | $12.11 | $20.47 | $36.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.11 / $12.41 / $29.50
| Professional | | $12.11 | $12.41 | $29.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.20 / $27.40 / $51.50
| Professional | | $20.20 | $27.40 | $51.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.59 / $12.28 / $12.28
| Facility | | $11.59 | $12.28 | $12.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $12.28 / $14.62
| Professional | | $12.28 | $12.28 | $14.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.27 / $18.27 / $21.20
| Facility | | $18.27 | $18.27 | $21.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.27 / $18.27 / $21.20
| Professional | | $18.27 | $18.27 | $21.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $13.02 / $22.47
| Professional | | $12.28 | $13.02 | $22.47 |