- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.13 / $37.46 / $116.10
| Facility | | $16.13 | $37.46 | $116.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.58 / $14.49 / $28.34
| Professional | | $12.58 | $14.49 | $28.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.76 / $11.29 / $12.46
| Professional | | $9.76 | $11.29 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.07 / $37.40 / $100.00
| Facility | | $17.07 | $37.40 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $14.80 / $30.00
| Professional | | $8.02 | $14.80 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $31.57 / $47.57
| Facility | | $11.26 | $31.57 | $47.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.36 / $21.44 / $32.63
| Professional | | $11.36 | $21.44 | $32.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.57 / $15.69 / $17.25
| Professional | | $11.57 | $15.69 | $17.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.26 / $17.07 / $35.89
| Facility | | $16.26 | $17.07 | $35.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.26 / $24.39 / $44.72
| Facility | | $16.26 | $24.39 | $44.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.63 / $14.63 / $14.63
| Professional | | $14.63 | $14.63 | $14.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.70 / $26.83 / $44.72
| Facility | | $18.70 | $26.83 | $44.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.20 / $16.26 / $44.01
| Professional | | $12.20 | $16.26 | $44.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.83 / $6.83 / $16.26
| Professional | | $6.83 | $6.83 | $16.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.32 / $7.32 / $8.42
| Professional | | $7.32 | $7.32 | $8.42 |