- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.90 / $5.98 / $6.46
| Facility | | $5.90 | $5.98 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.46 / $6.43 / $8.02
| Professional | | $5.46 | $6.43 | $8.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $11.10 / $11.10
| Professional | | $5.62 | $11.10 | $11.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.03 / $11.57 / $24.95
| Facility | | $7.03 | $11.57 | $24.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $7.49 / $7.49
| Professional | | $7.49 | $7.49 | $7.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.83 / $9.10
| Professional | | $5.01 | $6.83 | $9.10 |
- 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
- $10.67 / $10.67 / $10.67
| Facility | | $10.67 | $10.67 | $10.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $3.72
| Professional | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.47 / $90.00 / $90.00
| Facility | | $18.47 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.00 / $148.41 / $154.35
| Professional | | $80.00 | $148.41 | $154.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.06 / $10.66 / $31.19
| Facility | | $6.06 | $10.66 | $31.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $8.65 / $9.96
| Professional | | $7.74 | $8.65 | $9.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.92 / $10.21 / $15.93
| Professional | | $8.92 | $10.21 | $15.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.15 / $10.83 / $31.19
| Facility | | $6.15 | $10.83 | $31.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $7.56
| Professional | | $3.72 | $3.72 | $7.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $4.12 / $6.24
| Professional | | $3.22 | $4.12 | $6.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.10 / $9.10 / $12.29
| Professional | | $9.10 | $9.10 | $12.29 |