- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.66 / $54.06 / $121.50
| Facility | | $14.66 | $54.06 | $121.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.97 / $12.36 / $14.18
| Professional | | $10.97 | $12.36 | $14.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $9.84 / $9.84
| Professional | | $8.51 | $9.84 | $9.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $28.94 / $100.00
| Facility | | $14.89 | $28.94 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $12.90 / $24.45
| Professional | | $7.00 | $12.90 | $24.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.82 / $29.04 / $49.79
| Facility | | $9.82 | $29.04 | $49.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.81 / $18.76 / $28.24
| Professional | | $9.81 | $18.76 | $28.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $13.68 / $15.04
| Professional | | $10.09 | $13.68 | $15.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.18 / $14.89 / $32.79
| Facility | | $14.18 | $14.89 | $32.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.18 / $21.27 / $39.00
| Facility | | $14.18 | $21.27 | $39.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $12.76 / $12.76
| Professional | | $12.76 | $12.76 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.30 / $23.40 / $39.00
| Facility | | $16.30 | $23.40 | $39.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $14.18 / $38.61
| Professional | | $10.64 | $14.18 | $38.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $5.96 / $14.18
| Professional | | $5.96 | $5.96 | $14.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $6.38 / $7.35
| Professional | | $6.38 | $6.38 | $7.35 |