- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.29 / $35.45 / $148.22
| Facility | | $13.29 | $35.45 | $148.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $12.12 / $23.30
| Professional | | $10.71 | $12.12 | $23.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $8.02
| Professional | | $8.02 | $8.02 | $8.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.06 / $27.35 / $100.00
| Facility | | $14.06 | $27.35 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $12.05 / $23.10
| Professional | | $6.61 | $12.05 | $23.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.27 / $27.41 / $42.10
| Facility | | $9.27 | $27.41 | $42.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $17.86 / $26.78
| Professional | | $9.30 | $17.86 | $26.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.53 / $12.92 / $14.21
| Professional | | $9.53 | $12.92 | $14.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.39 / $14.06 / $30.75
| Facility | | $13.39 | $14.06 | $30.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.39 / $20.09 / $36.82
| Facility | | $13.39 | $20.09 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $12.05
| Professional | | $12.05 | $12.05 | $12.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.40 / $22.09 / $36.82
| Facility | | $15.40 | $22.09 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $13.39 / $35.93
| Professional | | $10.03 | $13.39 | $35.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $5.62 / $15.00
| Professional | | $5.62 | $5.62 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $6.94
| Professional | | $6.03 | $6.03 | $6.94 |