- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $52.83 / $106.20
| Facility | | $14.13 | $52.83 | $106.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $12.71 / $14.60
| Professional | | $7.74 | $12.71 | $14.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.76 / $8.76 / $10.14
| Professional | | $8.76 | $8.76 | $10.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.33 / $29.81 / $100.00
| Facility | | $15.33 | $29.81 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $13.29 / $25.20
| Professional | | $7.21 | $13.29 | $25.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.11 / $27.52 / $42.71
| Facility | | $10.11 | $27.52 | $42.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $19.20 / $29.22
| Professional | | $10.16 | $19.20 | $29.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $14.08 / $15.48
| Professional | | $10.39 | $14.08 | $15.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.60 / $15.33 / $32.22
| Facility | | $14.60 | $15.33 | $32.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.60 / $21.90 / $40.15
| Facility | | $14.60 | $21.90 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.14 / $13.14 / $13.14
| Professional | | $13.14 | $13.14 | $13.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.79 / $24.09 / $40.15
| Facility | | $16.79 | $24.09 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $14.60 / $39.52
| Professional | | $10.95 | $14.60 | $39.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $6.13 / $17.52
| Professional | | $6.13 | $6.13 | $17.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.57 / $6.57 / $7.56
| Professional | | $6.57 | $6.57 | $7.56 |