- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.38 / $67.30 / $185.47
| Facility | | $14.38 | $67.30 | $185.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.37 / $13.12 / $16.76
| Professional | | $12.37 | $13.12 | $16.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $8.74 / $10.11
| Professional | | $8.74 | $8.74 | $10.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.30 / $29.74 / $100.00
| Facility | | $15.30 | $29.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $13.70 / $25.15
| Professional | | $7.20 | $13.70 | $25.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.08 / $29.83 / $50.60
| Facility | | $10.08 | $29.83 | $50.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $18.95 / $29.22
| Professional | | $10.16 | $18.95 | $29.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.37 / $14.06 / $15.46
| Professional | | $10.37 | $14.06 | $15.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.57 / $16.03 / $37.93
| Facility | | $14.57 | $16.03 | $37.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.57 / $21.86 / $40.07
| Facility | | $14.57 | $21.86 | $40.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $13.11 / $13.11
| Professional | | $13.11 | $13.11 | $13.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.76 / $24.04 / $40.07
| Facility | | $16.76 | $24.04 | $40.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $14.57 / $39.52
| Professional | | $10.93 | $14.57 | $39.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.12 / $6.12 / $14.57
| Professional | | $6.12 | $6.12 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.56 / $6.56 / $7.55
| Professional | | $6.56 | $6.56 | $7.55 |