- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.37 / $12.62 / $12.86
| Facility | | $12.37 | $12.62 | $12.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $12.86 / $20.86
| Professional | | $11.73 | $12.86 | $20.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.50 / $16.50 / $16.50
| Professional | | $16.50 | $16.50 | $16.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.71 / $27.71 / $27.71
| Facility | | $27.71 | $27.71 | $27.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.39 / $15.39 / $15.39
| Facility | | $15.39 | $15.39 | $15.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $11.23
| Professional | | $11.23 | $11.23 | $11.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $128.41 / $128.41
| Facility | | $80.00 | $128.41 | $128.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.63 / $138.63 / $202.05
| Professional | | $138.63 | $138.63 | $202.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.93 / $18.51 / $27.71
| Facility | | $7.93 | $18.51 | $27.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.93 / $24.94 / $27.71
| Professional | | $7.93 | $24.94 | $27.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.20 / $28.26 / $62.35
| Professional | | $21.20 | $28.26 | $62.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.93 / $16.64 / $27.71
| Facility | | $7.93 | $16.64 | $27.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $22.41
| Professional | | $11.23 | $11.23 | $22.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.44 / $12.18 / $14.34
| Facility | | $9.44 | $12.18 | $14.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.24 / $14.62 / $17.63
| Professional | | $10.24 | $14.62 | $17.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.76 / $15.01 / $27.71
| Professional | | $14.76 | $15.01 | $27.71 |