- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.60 / $39.64 / $91.80
| Facility | | $11.60 | $39.64 | $91.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $10.97 / $20.48
| Professional | | $9.36 | $10.97 | $20.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.27 / $8.41 / $9.27
| Professional | | $7.27 | $8.41 | $9.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $33.29 / $100.00
| Facility | | $12.72 | $33.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.98 / $11.38 / $20.90
| Professional | | $5.98 | $11.38 | $20.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $24.79 / $35.42
| Facility | | $8.38 | $24.79 | $35.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $16.07 / $24.35
| Professional | | $8.44 | $16.07 | $24.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.62 / $11.68 / $12.84
| Professional | | $8.62 | $11.68 | $12.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $12.72 / $28.70
| Facility | | $12.11 | $12.72 | $28.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.90 / $12.11 / $12.11
| Facility | | $10.90 | $12.11 | $12.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.90 / $10.90 / $10.90
| Professional | | $10.90 | $10.90 | $10.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.93 / $19.98 / $33.29
| Facility | | $13.93 | $19.98 | $33.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.08 / $12.11 / $32.34
| Professional | | $9.08 | $12.11 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $5.09 / $12.11
| Professional | | $5.09 | $5.09 | $12.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.27 / $6.27 / $6.27
| Professional | | $6.27 | $6.27 | $6.27 |