- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $12.00 / $17.84
| Facility | | $9.60 | $12.00 | $17.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.56 / $7.60 / $23.42
| Professional | | $6.56 | $7.60 | $23.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.20 / $20.80 / $22.00
| Facility | | $17.20 | $20.80 | $22.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $3.20 / $32.63
| Professional | | $3.20 | $3.20 | $32.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.34 / $19.55 / $20.32
| Facility | | $5.34 | $19.55 | $20.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.63 / $25.27 / $38.77
| Facility | | $21.63 | $25.27 | $38.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $21.54 / $24.48
| Professional | | $9.50 | $21.54 | $24.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $5.74 / $9.60
| Facility | | $5.31 | $5.74 | $9.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $6.56 / $100.00
| Facility | | $5.31 | $6.56 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.58 / $6.54 / $17.48
| Professional | | $4.58 | $6.54 | $17.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $12.00 / $85.00
| Professional | | $4.00 | $12.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $5.74 / $9.60
| Facility | | $5.31 | $5.74 | $9.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $19.80 / $74.67
| Professional | | $9.50 | $19.80 | $74.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.00 / $50.00 / $100.00
| Facility | | $16.00 | $50.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.92 / $4.00 / $5.75
| Professional | | $3.92 | $4.00 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.04 / $17.04 / $34.51
| Professional | | $17.04 | $17.04 | $34.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.77 / $34.51 / $43.68
| Professional | | $23.77 | $34.51 | $43.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.34 / $6.40 / $19.13
| Professional | | $4.34 | $6.40 | $19.13 |