- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.75 / $12.92 / $13.96
| Facility | | $12.75 | $12.92 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.76 / $13.30 / $17.23
| Professional | | $9.76 | $13.30 | $17.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.21 / $16.21 / $16.21
| Professional | | $16.21 | $16.21 | $16.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.06 / $23.06 / $23.06
| Facility | | $23.06 | $23.06 | $23.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $8.02
| Professional | | $8.02 | $8.02 | $8.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.95 / $92.10 / $93.48
| Facility | | $39.95 | $92.10 | $93.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.60 / $157.25 / $163.54
| Professional | | $147.60 | $157.25 | $163.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.09 / $19.68 / $36.67
| Facility | | $13.09 | $19.68 | $36.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $18.70 / $19.68
| Professional | | $16.73 | $18.70 | $19.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.29 / $22.08 / $34.44
| Professional | | $19.29 | $22.08 | $34.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.09 / $19.68 / $36.67
| Facility | | $13.09 | $19.68 | $36.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $16.36
| Professional | | $8.02 | $8.02 | $16.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $8.93 / $13.52
| Professional | | $6.96 | $8.93 | $13.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.68 / $19.68 / $26.57
| Professional | | $19.68 | $19.68 | $26.57 |