- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.83 / $14.02 / $15.70
| Facility | | $13.83 | $14.02 | $15.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.96 / $14.20 / $18.69
| Professional | | $9.96 | $14.20 | $18.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.50 / $27.14 / $58.54
| Facility | | $16.50 | $27.14 | $58.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.57 / $17.57 / $17.57
| Professional | | $17.57 | $17.57 | $17.57 |
- 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
- $25.02 / $25.02 / $25.02
| Facility | | $25.02 | $25.02 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.34 / $99.92 / $101.41
| Facility | | $43.34 | $99.92 | $101.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.13 / $210.25 / $218.66
| Professional | | $160.13 | $210.25 | $218.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.20 / $21.35 / $44.25
| Facility | | $14.20 | $21.35 | $44.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.14 / $20.28 / $21.35
| Professional | | $18.14 | $20.28 | $21.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.28 / $23.48 / $37.36
| Professional | | $20.28 | $23.48 | $37.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.20 / $21.35 / $44.25
| Facility | | $14.20 | $21.35 | $44.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $8.71 / $17.73
| Professional | | $8.71 | $8.71 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.54 / $9.67 / $14.66
| Professional | | $7.54 | $9.67 | $14.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.35 / $21.35 / $28.82
| Professional | | $21.35 | $21.35 | $28.82 |