- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.33 / $29.69 / $78.13
| Facility | | $13.33 | $29.69 | $78.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $12.54 / $22.59
| Professional | | $10.73 | $12.54 | $22.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $27.65 / $70.00
| Facility | | $14.89 | $27.65 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.85 / $12.76 / $23.90
| Professional | | $6.85 | $12.76 | $23.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $25.15 / $41.49
| Facility | | $9.60 | $25.15 | $41.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $17.89 / $27.76
| Professional | | $9.64 | $17.89 | $27.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $13.68 / $15.04
| Professional | | $10.09 | $13.68 | $15.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.18 / $14.89 / $31.30
| Facility | | $14.18 | $14.89 | $31.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.18 / $21.27 / $39.00
| Facility | | $14.18 | $21.27 | $39.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $12.76 / $12.76
| Professional | | $12.76 | $12.76 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.30 / $23.27 / $39.00
| Facility | | $16.30 | $23.27 | $39.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $14.18 / $38.61
| Professional | | $10.64 | $14.18 | $38.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $5.96 / $14.18
| Professional | | $5.96 | $5.96 | $14.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $6.38 / $7.35
| Professional | | $6.38 | $6.38 | $7.35 |