- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.91 / $22.41 / $77.53
| Facility | | $12.91 | $22.41 | $77.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $13.23 / $14.07
| Professional | | $7.04 | $13.23 | $14.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.77 / $25.33 / $100.00
| Facility | | $14.77 | $25.33 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $10.55 / $22.65
| Professional | | $5.63 | $10.55 | $22.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.15 / $20.68 / $36.35
| Facility | | $4.15 | $20.68 | $36.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.44 / $14.62 / $20.13
| Professional | | $7.44 | $14.62 | $20.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $13.57 / $14.92
| Professional | | $10.01 | $13.57 | $14.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.07 / $14.07 / $31.06
| Facility | | $14.07 | $14.07 | $31.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.07 / $21.11 / $38.69
| Facility | | $14.07 | $21.11 | $38.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $12.66 / $12.66
| Professional | | $12.66 | $12.66 | $12.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.77 / $23.09 / $38.69
| Facility | | $14.77 | $23.09 | $38.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.10 / $14.07 / $37.72
| Professional | | $7.10 | $14.07 | $37.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $5.91 / $14.07
| Professional | | $3.52 | $5.91 | $14.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $6.33 / $7.29
| Professional | | $6.33 | $6.33 | $7.29 |