- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.28 / $9.47 / $9.66
| Facility | | $9.28 | $9.47 | $9.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.77 / $9.66 / $15.67
| Professional | | $8.77 | $9.66 | $15.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.39 / $12.39 / $12.39
| Professional | | $12.39 | $12.39 | $12.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.82 / $20.82 / $20.82
| Facility | | $20.82 | $20.82 | $20.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.40 / $13.40 / $13.40
| Facility | | $13.40 | $13.40 | $13.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $13.40
| Professional | | $9.77 | $9.77 | $13.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $96.08 / $96.08
| Facility | | $80.00 | $96.08 | $96.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.06 / $103.06 / $151.35
| Professional | | $103.06 | $103.06 | $151.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.94 / $14.07 / $20.82
| Facility | | $5.94 | $14.07 | $20.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.94 / $18.73 / $20.82
| Professional | | $5.94 | $18.73 | $20.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.18 / $22.09 / $79.73
| Professional | | $20.18 | $22.09 | $79.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.94 / $13.91 / $20.82
| Facility | | $5.94 | $13.91 | $20.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $13.80
| Professional | | $9.77 | $9.77 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $9.11 / $10.74
| Facility | | $7.10 | $9.11 | $10.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.67 / $11.09 / $13.21
| Professional | | $7.67 | $11.09 | $13.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.06 / $11.78 / $20.82
| Professional | | $11.06 | $11.78 | $20.82 |