- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.12 / $24.03 / $41.40
| Facility | | $11.12 | $24.03 | $41.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.93 / $10.19 / $13.73
| Professional | | $9.93 | $10.19 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $13.73 / $35.70
| Facility | | $13.73 | $13.73 | $35.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.78 / $8.30 / $27.27
| Professional | | $6.78 | $8.30 | $27.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.24 / $13.73 / $13.73
| Facility | | $8.24 | $13.73 | $13.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $13.73 / $13.73
| Professional | | $10.02 | $13.73 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $27.56 / $35.31
| Facility | | $9.60 | $27.56 | $35.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $15.34 / $66.18
| Professional | | $10.19 | $15.34 | $66.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $20.60 / $332.00
| Facility | | $12.00 | $20.60 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.27 / $8.24 / $25.13
| Professional | | $6.27 | $8.24 | $25.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.61 / $10.61 / $10.61
| Facility | | $10.61 | $10.61 | $10.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.61 / $13.04 / $16.92
| Professional | | $10.61 | $13.04 | $16.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.06 / $34.43 / $152.80
| Facility | | $33.06 | $34.43 | $152.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $33.20 / $254.50
| Facility | | $13.73 | $33.20 | $254.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $16.20 / $28.04
| Professional | | $10.56 | $16.20 | $28.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $8.24 / $30.00
| Professional | | $5.77 | $8.24 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.79 / $15.79 / $29.60
| Facility | | $15.79 | $15.79 | $29.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.35 / $14.39 / $18.91
| Professional | | $11.35 | $14.39 | $18.91 |