- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.92 / $45.10 / $120.60
| Facility | | $10.92 | $45.10 | $120.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.93 / $9.93 / $15.64
| Professional | | $8.93 | $9.93 | $15.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.83 / $7.91 / $7.91
| Professional | | $6.83 | $7.91 | $7.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.96 / $22.78 / $100.00
| Facility | | $11.96 | $22.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $10.25 / $19.64
| Professional | | $5.62 | $10.25 | $19.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.88 / $23.31 / $33.29
| Facility | | $7.88 | $23.31 | $33.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.92 / $15.18 / $22.89
| Professional | | $7.92 | $15.18 | $22.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $10.99 / $12.08
| Professional | | $8.11 | $10.99 | $12.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.39 / $11.96 / $25.63
| Facility | | $11.39 | $11.96 | $25.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.39 / $17.09 / $31.32
| Facility | | $11.39 | $17.09 | $31.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.25 / $10.25 / $10.25
| Professional | | $10.25 | $10.25 | $10.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.10 / $18.79 / $31.32
| Facility | | $13.10 | $18.79 | $31.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.53 / $11.39 / $30.54
| Professional | | $8.53 | $11.39 | $30.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.78 / $4.78 / $12.76
| Professional | | $4.78 | $4.78 | $12.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $5.90
| Professional | | $5.13 | $5.13 | $5.90 |