- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.56 / $21.28 / $73.61
| Facility | | $12.56 | $21.28 | $73.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $12.56 / $19.77
| Professional | | $7.48 | $12.56 | $19.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.03 / $26.72 / $100.00
| Facility | | $14.03 | $26.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.34 / $10.02 / $22.39
| Professional | | $5.34 | $10.02 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.97 / $19.62 / $34.47
| Facility | | $5.97 | $19.62 | $34.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.10 / $15.28 / $19.10
| Professional | | $7.10 | $15.28 | $19.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.51 / $12.89 / $14.17
| Professional | | $9.51 | $12.89 | $14.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.36 / $14.03 / $29.49
| Facility | | $13.36 | $14.03 | $29.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.36 / $20.04 / $36.74
| Facility | | $13.36 | $20.04 | $36.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $12.02
| Professional | | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.36 / $21.92 / $36.74
| Facility | | $15.36 | $21.92 | $36.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $13.36 / $35.93
| Professional | | $10.02 | $13.36 | $35.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $5.61 / $13.36
| Professional | | $4.94 | $5.61 | $13.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $6.01 / $6.92
| Professional | | $6.01 | $6.01 | $6.92 |