- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.68 / $12.68 / $14.03
| Facility | | $12.68 | $12.68 | $14.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.67 / $12.68 / $13.94
| Professional | | $12.67 | $12.68 | $13.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.64 / $9.64 / $12.05
| Facility | | $9.64 | $9.64 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.00 / $18.00 / $19.97
| Professional | | $18.00 | $18.00 | $19.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.97 / $12.70 / $12.70
| Facility | | $11.97 | $12.70 | $12.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.97 / $11.97 / $11.97
| Professional | | $11.97 | $11.97 | $11.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.36 / $20.91 / $332.00
| Facility | | $11.36 | $20.91 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.63 / $20.91 / $20.91
| Professional | | $13.63 | $20.91 | $20.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.46 / $20.46 / $20.46
| Facility | | $20.46 | $20.46 | $20.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.46 / $20.46 / $22.07
| Professional | | $20.46 | $20.46 | $22.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.13 / $19.13 / $19.13
| Facility | | $19.13 | $19.13 | $19.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.97 / $12.70 / $597.00
| Facility | | $11.97 | $12.70 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.97 / $13.00 / $14.45
| Professional | | $11.97 | $13.00 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.46 / $51.46 / $74.81
| Professional | | $51.46 | $51.46 | $74.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.46 / $20.46 / $20.46
| Facility | | $20.46 | $20.46 | $20.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.39 / $20.46 / $22.07
| Professional | | $12.39 | $20.46 | $22.07 |