- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.93 / $29.90 / $102.96
| Facility | | $7.93 | $29.90 | $102.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $4.55 / $6.90
| Professional | | $4.37 | $4.55 | $6.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.36 / $14.95 / $15.81
| Facility | | $12.36 | $14.95 | $15.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $2.48 / $23.46
| Professional | | $2.48 | $2.48 | $23.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $14.05 / $14.61
| Facility | | $3.64 | $14.05 | $14.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $18.95 / $29.08
| Facility | | $16.22 | $18.95 | $29.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $15.49 / $17.60
| Professional | | $6.61 | $15.49 | $17.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.48 / $4.59 / $6.90
| Facility | | $4.48 | $4.59 | $6.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.48 / $5.18 / $100.00
| Facility | | $4.48 | $5.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $5.52 / $14.74
| Professional | | $3.34 | $5.52 | $14.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $15.87 / $85.00
| Professional | | $2.88 | $15.87 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.48 / $4.59 / $6.90
| Facility | | $4.48 | $4.59 | $6.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.84 / $14.26 / $36.04
| Professional | | $6.84 | $14.26 | $36.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.50 / $11.50 / $100.00
| Facility | | $11.50 | $11.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $3.27 / $4.97
| Professional | | $3.05 | $3.27 | $4.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.24 / $12.24 / $13.39
| Professional | | $12.24 | $12.24 | $13.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.39 / $20.05 / $31.40
| Professional | | $13.39 | $20.05 | $31.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $4.59 / $14.74
| Professional | | $2.88 | $4.59 | $14.74 |