- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.80 / $47.65 / $129.28
| Facility | | $14.80 | $47.65 | $129.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $11.16 / $22.06
| Professional | | $9.60 | $11.16 | $22.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.45 / $8.61 / $8.61
| Professional | | $7.45 | $8.61 | $8.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.03 / $24.99 / $100.00
| Facility | | $13.03 | $24.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $11.29 / $21.40
| Professional | | $6.13 | $11.29 | $21.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.60 / $25.42 / $36.32
| Facility | | $8.60 | $25.42 | $36.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.61 / $16.52 / $24.84
| Professional | | $8.61 | $16.52 | $24.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $11.97 / $13.16
| Professional | | $8.83 | $11.97 | $13.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $13.03 / $31.78
| Facility | | $12.41 | $13.03 | $31.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $18.62 / $34.13
| Facility | | $12.41 | $18.62 | $34.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.17 / $11.17 / $11.17
| Professional | | $11.17 | $11.17 | $11.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.27 / $20.36 / $34.13
| Facility | | $14.27 | $20.36 | $34.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.31 / $12.41 / $33.22
| Professional | | $9.31 | $12.41 | $33.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $5.21 / $12.41
| Professional | | $5.21 | $5.21 | $12.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.58 / $5.58 / $6.43
| Professional | | $5.58 | $5.58 | $6.43 |