- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $15.14 / $25.12
| Facility | | $10.47 | $15.14 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $13.49
| Professional | | $10.00 | $10.00 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $17.78 / $20.89
| Facility | | $9.77 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $11.75
| Professional | | $10.47 | $10.47 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $22.39 / $27.54
| Professional | | $16.22 | $22.39 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.96 / $20.89
| Facility | | $10.47 | $10.96 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $11.48 / $16.22
| Professional | | $10.00 | $11.48 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $12.88 / $21.38
| Facility | | $10.47 | $12.88 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $10.47 / $19.05
| Facility | | $9.55 | $10.47 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $12.88 / $79.43
| Professional | | $10.47 | $12.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $16.60 / $33.88
| Facility | | $10.47 | $16.60 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $11.48
| Professional | | $10.47 | $10.47 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $25.12
| Facility | | $10.47 | $10.47 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $11.75
| Professional | | $10.47 | $10.47 | $11.75 |