- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.82 / $37.11 / $191.94
| Facility | | $11.82 | $37.11 | $191.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $10.81 / $20.78
| Professional | | $9.22 | $10.81 | $20.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $7.15 / $7.15
| Professional | | $7.15 | $7.15 | $7.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.52 / $23.84 / $86.00
| Facility | | $12.52 | $23.84 | $86.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $10.85 / $22.21
| Professional | | $5.89 | $10.85 | $22.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.25 / $24.41 / $34.88
| Facility | | $8.25 | $24.41 | $34.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $15.63 / $23.86
| Professional | | $8.26 | $15.63 | $23.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $11.50 / $12.65
| Professional | | $8.48 | $11.50 | $12.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.92 / $12.52 / $30.75
| Facility | | $11.92 | $12.52 | $30.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.92 / $17.88 / $32.78
| Facility | | $11.92 | $17.88 | $32.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $10.73
| Professional | | $10.73 | $10.73 | $10.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.71 / $19.67 / $32.78
| Facility | | $13.71 | $19.67 | $32.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $11.92 / $32.34
| Professional | | $8.94 | $11.92 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $11.92
| Professional | | $5.01 | $5.01 | $11.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.36 / $5.36 / $6.17
| Professional | | $5.36 | $5.36 | $6.17 |