- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.03 / $26.20 / $94.61
| Facility | | $10.03 | $26.20 | $94.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $10.10 / $21.36
| Professional | | $8.69 | $10.10 | $21.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.59 / $70.00 / $70.00
| Facility | | $13.59 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $24.07 / $80.63
| Professional | | $13.86 | $24.07 | $80.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.53 / $18.27 / $29.45
| Professional | | $10.53 | $18.27 | $29.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $21.12 / $27.00
| Facility | | $12.00 | $21.12 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $21.77 / $27.00
| Professional | | $11.04 | $21.77 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $70.00
| Professional | | $70.00 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.55 / $19.12 / $19.43
| Facility | | $13.55 | $19.12 | $19.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $13.25 / $13.59
| Facility | | $13.25 | $13.25 | $13.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.97 / $22.45 / $27.61
| Professional | | $14.97 | $22.45 | $27.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.86 / $13.86 / $13.86
| Facility | | $13.86 | $13.86 | $13.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $20.07 / $30.97
| Professional | | $13.86 | $20.07 | $30.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.91 / $10.83 / $29.43
| Professional | | $7.91 | $10.83 | $29.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.18 / $10.18 / $10.18
| Professional | | $10.18 | $10.18 | $10.18 |