- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.40 / $23.63 / $42.35
| Facility | | $10.40 | $23.63 | $42.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.88 / $8.92 / $12.63
| Professional | | $7.88 | $8.92 | $12.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $6.61 / $20.50
| Professional | | $6.61 | $6.61 | $20.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $14.86 / $14.86
| Facility | | $14.86 | $14.86 | $14.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.85 / $14.86 / $14.86
| Professional | | $10.85 | $14.86 | $14.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.78 / $30.39 / $38.93
| Facility | | $14.78 | $30.39 | $38.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.89 / $21.50 / $71.63
| Professional | | $11.89 | $21.50 | $71.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $31.21 / $332.00
| Facility | | $14.86 | $31.21 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.60 / $19.62 / $32.25
| Professional | | $15.60 | $19.62 | $32.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $14.68 / $26.95
| Professional | | $12.63 | $14.68 | $26.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.78 / $36.61 / $52.08
| Facility | | $14.78 | $36.61 | $52.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $18.57 / $34.18
| Professional | | $9.66 | $18.57 | $34.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $8.92 / $22.52
| Professional | | $6.24 | $8.92 | $22.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $17.09 / $17.09
| Facility | | $14.86 | $17.09 | $17.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $14.86 / $17.86
| Professional | | $12.63 | $14.86 | $17.86 |