- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.11 / $16.71 / $124.36
| Facility | | $8.11 | $16.71 | $124.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $6.40 / $9.55
| Professional | | $3.25 | $6.40 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $24.83
| Facility | | $9.55 | $9.55 | $24.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $4.13 / $14.01
| Professional | | $2.42 | $4.13 | $14.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.73 / $9.55 / $9.55
| Facility | | $5.73 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.97 / $9.55 / $9.55
| Professional | | $6.97 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.67 / $20.00 / $50.00
| Facility | | $6.67 | $20.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.46 / $9.50 / $46.03
| Professional | | $5.46 | $9.50 | $46.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $12.42 / $332.00
| Facility | | $5.50 | $12.42 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $5.73 / $17.48
| Professional | | $3.82 | $5.73 | $17.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.41 / $9.07 / $10.73
| Professional | | $6.41 | $9.07 | $10.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.52 / $22.98 / $110.01
| Facility | | $11.52 | $22.98 | $110.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $9.19 / $15.84
| Professional | | $5.73 | $9.19 | $15.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $4.30 / $14.03
| Professional | | $3.36 | $4.30 | $14.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.98 / $10.98 / $26.16
| Facility | | $10.98 | $10.98 | $26.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.41 / $9.42 / $11.48
| Professional | | $6.41 | $9.42 | $11.48 |