- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.47 / $41.98 / $160.15
| Facility | | $11.47 | $41.98 | $160.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $10.59 / $19.37
| Professional | | $9.17 | $10.59 | $19.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.11 / $7.11 / $7.11
| Professional | | $7.11 | $7.11 | $7.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $24.20 / $144.00
| Facility | | $12.44 | $24.20 | $144.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.85 / $10.78 / $21.00
| Professional | | $5.85 | $10.78 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.19 / $24.26 / $38.46
| Facility | | $8.19 | $24.26 | $38.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $15.44 / $23.86
| Professional | | $8.26 | $15.44 | $23.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $11.43 / $12.57
| Professional | | $8.44 | $11.43 | $12.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.85 / $12.44 / $27.68
| Facility | | $11.85 | $12.44 | $27.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.85 / $17.78 / $32.59
| Facility | | $11.85 | $17.78 | $32.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.67 / $10.67 / $10.67
| Professional | | $10.67 | $10.67 | $10.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.63 / $19.55 / $32.59
| Facility | | $13.63 | $19.55 | $32.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.89 / $11.85 / $32.34
| Professional | | $8.89 | $11.85 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.98 / $4.98 / $11.85
| Professional | | $4.98 | $4.98 | $11.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.33 / $5.33 / $6.14
| Professional | | $5.33 | $5.33 | $6.14 |