- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $25.70 / $40.74
| Facility | | $9.12 | $25.70 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $8.91 / $21.38
| Professional | | $7.94 | $8.91 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $11.22 / $14.79
| Professional | | $9.55 | $11.22 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $67.61 / $5,011.87
| Facility | | $46.77 | $67.61 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $10.00 / $16.98
| Professional | | $9.77 | $10.00 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $12.88 / $20.42
| Professional | | $7.76 | $12.88 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $13.49 / $16.22
| Professional | | $10.23 | $13.49 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $11.48 / $21.38
| Professional | | $9.77 | $11.48 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $9.77 / $10.00
| Professional | | $9.12 | $9.77 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $25.70 / $40.74
| Facility | | $10.96 | $25.70 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.47 / $25.12
| Professional | | $7.94 | $10.47 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $17.38 / $21.38
| Professional | | $10.00 | $17.38 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $11.22 / $11.22
| Facility | | $9.55 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $9.55 / $12.59
| Professional | | $5.75 | $9.55 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $10.72 / $17.78
| Professional | | $7.59 | $10.72 | $17.78 |