- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.63 / $55.47 / $188.88
| Facility | | $13.63 | $55.47 | $188.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.63 / $12.45 / $24.92
| Professional | | $8.63 | $12.45 | $24.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $9.53 / $9.53
| Professional | | $8.24 | $9.53 | $9.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $26.77 / $96.00
| Facility | | $14.42 | $26.77 | $96.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.78 / $12.91 / $23.93
| Professional | | $6.78 | $12.91 | $23.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $28.10 / $49.79
| Facility | | $9.50 | $28.10 | $49.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $17.89 / $27.27
| Professional | | $9.47 | $17.89 | $27.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $13.25 / $14.57
| Professional | | $9.77 | $13.25 | $14.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $15.10 / $31.78
| Facility | | $13.73 | $15.10 | $31.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $20.60 / $37.76
| Facility | | $13.73 | $20.60 | $37.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.36 / $12.36 / $12.36
| Professional | | $12.36 | $12.36 | $12.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.79 / $22.65 / $37.76
| Facility | | $15.79 | $22.65 | $37.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $13.73 / $36.83
| Professional | | $10.30 | $13.73 | $36.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $5.77 / $15.38
| Professional | | $5.77 | $5.77 | $15.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $6.18 / $7.11
| Professional | | $6.18 | $6.18 | $7.11 |