- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $8.91
| Facility | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.96 / $15.85
| Professional | | $7.08 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $28.18
| Facility | | $16.98 | $16.98 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $18.20
| Professional | | $15.85 | $15.85 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $52.48 / $83.18
| Facility | | $44.67 | $52.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $24.55 / $32.36
| Professional | | $6.92 | $24.55 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $12.88 / $24.55
| Facility | | $9.33 | $12.88 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $23.99 / $30.20
| Professional | | $15.49 | $23.99 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $13.80 / $33.88
| Facility | | $9.55 | $13.80 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $8.32 / $125.89
| Professional | | $7.08 | $8.32 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $33.11 / $70.79
| Professional | | $9.77 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $25.70 / $46.77
| Professional | | $16.98 | $25.70 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $33.88 / $89.13
| Facility | | $33.88 | $33.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $25.70 / $131.83
| Professional | | $6.92 | $25.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $8.32 / $13.49
| Professional | | $5.62 | $8.32 | $13.49 |