- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $15.58 / $26.90
| Facility | | $8.02 | $15.58 | $26.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.08 / $9.44
| Professional | | $5.00 | $6.08 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.44 / $9.44 / $24.54
| Facility | | $9.44 | $9.44 | $24.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $4.83 / $16.48
| Professional | | $3.25 | $4.83 | $16.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.66 / $9.44 / $9.44
| Facility | | $5.66 | $9.44 | $9.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.89 / $9.44 / $9.44
| Professional | | $6.89 | $9.44 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $19.96 / $72.44
| Facility | | $6.60 | $19.96 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.19 / $10.59 / $45.50
| Professional | | $5.19 | $10.59 | $45.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.50 / $12.27 / $332.00
| Facility | | $4.50 | $12.27 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $5.66 / $17.28
| Professional | | $3.78 | $5.66 | $17.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.10 / $8.94 / $11.35
| Professional | | $6.10 | $8.94 | $11.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.43 / $22.98 / $125.71
| Facility | | $11.43 | $22.98 | $125.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.34 / $9.44 / $14.79
| Professional | | $5.34 | $9.44 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.66 / $13.88
| Professional | | $3.96 | $5.66 | $13.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.86 / $10.86 / $24.82
| Facility | | $10.86 | $10.86 | $24.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.10 / $8.97 / $19.89
| Professional | | $6.10 | $8.97 | $19.89 |