- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.81 / $22.08 / $63.91
| Facility | | $8.81 | $22.08 | $63.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.63 / $8.88 / $14.21
| Professional | | $6.63 | $8.88 | $14.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.68 / $5.68 / $5.68
| Professional | | $5.68 | $5.68 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.68 / $39.07 / $71.28
| Facility | | $14.68 | $39.07 | $71.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.28 / $11.60
| Professional | | $5.00 | $6.28 | $11.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.60 / $11.60 / $11.84
| Facility | | $11.60 | $11.60 | $11.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.27 / $26.03 / $59.51
| Facility | | $8.27 | $26.03 | $59.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.28 / $8.66 / $19.69
| Professional | | $6.28 | $8.66 | $19.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.78 / $70.00 / $94.00
| Facility | | $64.78 | $70.00 | $94.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.47 / $11.84 / $16.18
| Facility | | $9.47 | $11.84 | $16.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.66 / $11.84 / $15.43
| Professional | | $10.66 | $11.84 | $15.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.48 / $11.84 / $32.71
| Facility | | $9.48 | $11.84 | $32.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.28 / $9.11 / $17.12
| Professional | | $6.28 | $9.11 | $17.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.95 / $11.84 / $14.21
| Facility | | $6.95 | $11.84 | $14.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.97 / $6.77 / $9.67
| Professional | | $4.97 | $6.77 | $9.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $5.85 / $11.84
| Professional | | $4.62 | $5.85 | $11.84 |