- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.14 / $36.65 / $129.07
| Facility | | $12.14 | $36.65 | $129.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $11.71 / $23.40
| Professional | | $10.98 | $11.71 | $23.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.97 / $8.97 / $8.97
| Professional | | $8.97 | $8.97 | $8.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.57 / $26.37 / $100.00
| Facility | | $13.57 | $26.37 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $11.63 / $24.55
| Professional | | $6.38 | $11.63 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.93 / $26.46 / $44.94
| Facility | | $8.93 | $26.46 | $44.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $16.97 / $25.81
| Professional | | $8.94 | $16.97 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.19 / $12.46 / $13.70
| Professional | | $9.19 | $12.46 | $13.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $13.57 / $28.52
| Facility | | $12.92 | $13.57 | $28.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $19.38 / $35.53
| Facility | | $12.92 | $19.38 | $35.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $11.63 / $11.63
| Professional | | $11.63 | $11.63 | $11.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $21.32 / $35.53
| Facility | | $14.86 | $21.32 | $35.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.69 / $12.92 / $35.03
| Professional | | $9.69 | $12.92 | $35.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $6.46 / $14.47
| Professional | | $5.43 | $6.46 | $14.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.81 / $5.81 / $6.69
| Professional | | $5.81 | $5.81 | $6.69 |