- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.68 / $37.49 / $40.15
| Facility | | $10.68 | $37.49 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.43 / $10.68 / $11.53
| Professional | | $10.43 | $10.68 | $11.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.43 / $10.43 / $39.43
| Facility | | $10.43 | $10.43 | $39.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.43 / $10.43 / $10.43
| Professional | | $10.43 | $10.43 | $10.43 |
- 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
- $12.10 / $12.43 / $85.00
| Facility | | $12.10 | $12.43 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $7.87 / $7.87
| Professional | | $7.87 | $7.87 | $7.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.78 / $429.78 / $429.78
| Professional | | $429.78 | $429.78 | $429.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $12.57 / $22.26
| Facility | | $10.32 | $12.57 | $22.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.99 / $10.99 / $10.99
| Professional | | $10.99 | $10.99 | $10.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.90 / $12.15 / $19.94
| Professional | | $7.90 | $12.15 | $19.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $12.57 / $19.22
| Facility | | $10.32 | $12.57 | $19.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $7.87 / $7.87
| Professional | | $7.87 | $7.87 | $7.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.57 / $12.57 / $12.90
| Professional | | $12.57 | $12.57 | $12.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $10.68 / $14.42
| Professional | | $10.68 | $10.68 | $14.42 |