- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $12.09 / $13.06
| Facility | | $12.09 | $12.09 | $13.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.09 / $13.06 / $24.18
| Professional | | $12.09 | $13.06 | $24.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.46 / $16.46 / $20.71
| Professional | | $16.46 | $16.46 | $20.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.14 / $13.14 / $16.44
| Professional | | $13.14 | $13.14 | $16.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.61 / $27.61 / $27.61
| Facility | | $27.61 | $27.61 | $27.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.62 / $16.62 / $16.62
| Facility | | $16.62 | $16.62 | $16.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $12.13 / $16.62
| Professional | | $12.13 | $12.13 | $16.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.87 / $154.33 / $154.33
| Facility | | $132.87 | $154.33 | $154.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.21 / $157.21 / $229.05
| Professional | | $157.21 | $157.21 | $229.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.01 / $19.26 / $27.61
| Facility | | $8.01 | $19.26 | $27.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $24.85 / $31.76
| Professional | | $8.10 | $24.85 | $31.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.01 / $18.47 / $27.61
| Facility | | $8.01 | $18.47 | $27.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $12.13 / $17.73
| Professional | | $12.13 | $12.13 | $17.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.25 / $16.25 / $16.25
| Facility | | $16.25 | $16.25 | $16.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $15.29 / $18.69
| Professional | | $10.34 | $15.29 | $18.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.05 / $15.47 / $27.61
| Professional | | $15.05 | $15.47 | $27.61 |