- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $30.90 / $58.88
| Facility | | $10.96 | $30.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $16.98
| Professional | | $8.91 | $10.96 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $77.62 / $93.33
| Facility | | $58.88 | $77.62 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $6.61 / $10.96
| Professional | | $6.61 | $6.61 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $12.02 / $13.49
| Professional | | $11.48 | $12.02 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $29.51 / $75.86
| Facility | | $15.14 | $29.51 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $21.38
| Professional | | $17.78 | $17.78 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $16.22 / $20.89
| Professional | | $14.79 | $16.22 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $14.45 / $22.91
| Facility | | $11.22 | $14.45 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $30.90
| Professional | | $9.55 | $9.55 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $14.79 / $58.88
| Facility | | $10.47 | $14.79 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $14.79 / $30.20
| Professional | | $10.47 | $14.79 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $14.79 / $17.78
| Facility | | $8.91 | $14.79 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $7.41 / $16.98
| Professional | | $6.31 | $7.41 | $16.98 |