- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.13 / $29.39 / $70.54
| Facility | | $12.13 | $29.39 | $70.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.39 / $11.48 / $12.13
| Professional | | $8.39 | $11.48 | $12.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $7.74 / $7.74
| Professional | | $7.74 | $7.74 | $7.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.55 / $26.33 / $100.00
| Facility | | $13.55 | $26.33 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.37 / $11.74 / $22.25
| Professional | | $6.37 | $11.74 | $22.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $26.43 / $37.76
| Facility | | $8.91 | $26.43 | $37.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $16.85 / $25.81
| Professional | | $8.94 | $16.85 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.18 / $12.44 / $13.68
| Professional | | $9.18 | $12.44 | $13.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.90 / $13.55 / $32.79
| Facility | | $12.90 | $13.55 | $32.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.90 / $19.35 / $35.47
| Facility | | $12.90 | $19.35 | $35.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.61 / $11.61 / $11.61
| Professional | | $11.61 | $11.61 | $11.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.84 / $21.29 / $35.47
| Facility | | $14.84 | $21.29 | $35.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.68 / $12.90 / $35.03
| Professional | | $9.68 | $12.90 | $35.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.42 / $5.42 / $12.90
| Professional | | $5.42 | $5.42 | $12.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.81 / $5.81 / $6.68
| Professional | | $5.81 | $5.81 | $6.68 |