- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.04 / $27.18 / $94.00
| Facility | | $16.04 | $27.18 | $94.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.97 / $10.68 / $25.25
| Professional | | $8.97 | $10.68 | $25.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.91 / $34.11 / $188.00
| Facility | | $17.91 | $34.11 | $188.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.82 / $13.38 / $27.75
| Professional | | $6.82 | $13.38 | $27.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $34.93 / $51.81
| Facility | | $8.02 | $34.93 | $51.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $19.82 / $24.78
| Professional | | $9.00 | $19.82 | $24.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $16.46 / $18.10
| Professional | | $12.14 | $16.46 | $18.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.05 / $17.91 / $37.65
| Facility | | $17.05 | $17.91 | $37.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.05 / $25.59 / $46.92
| Facility | | $17.05 | $25.59 | $46.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.35 / $15.35 / $15.35
| Professional | | $15.35 | $15.35 | $15.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.62 / $28.00 / $46.92
| Facility | | $19.62 | $28.00 | $46.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $17.05 / $45.81
| Professional | | $12.80 | $17.05 | $45.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.05 / $20.47 / $20.47
| Facility | | $17.05 | $20.47 | $20.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.70 / $7.17 / $17.05
| Professional | | $6.70 | $7.17 | $17.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.68 / $7.68 / $8.84
| Professional | | $7.68 | $7.68 | $8.84 |