- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.34 / $35.67 / $93.81
| Facility | | $17.34 | $35.67 | $93.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.18 / $15.91 / $25.66
| Professional | | $9.18 | $15.91 | $25.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.21 / $39.88 / $100.00
| Facility | | $18.21 | $39.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $16.30 / $29.95
| Professional | | $8.56 | $16.30 | $29.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $27.95 / $50.72
| Facility | | $12.00 | $27.95 | $50.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $22.77 / $34.57
| Professional | | $12.05 | $22.77 | $34.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.34 / $16.73 / $18.40
| Professional | | $12.34 | $16.73 | $18.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.34 / $18.21 / $38.28
| Facility | | $17.34 | $18.21 | $38.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.34 / $26.01 / $47.69
| Facility | | $17.34 | $26.01 | $47.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.61 / $15.61 / $15.61
| Professional | | $15.61 | $15.61 | $15.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.94 / $28.61 / $47.69
| Facility | | $19.94 | $28.61 | $47.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $17.34 / $46.71
| Professional | | $13.01 | $17.34 | $46.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $7.28 / $17.34
| Professional | | $7.28 | $7.28 | $17.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $7.80 / $8.98
| Professional | | $7.80 | $7.80 | $8.98 |