- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.36 / $47.10 / $107.35
| Facility | | $11.36 | $47.10 | $107.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.57 / $10.54 / $16.60
| Professional | | $8.57 | $10.54 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $8.39 / $22.37
| Professional | | $7.25 | $8.39 | $22.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.69 / $24.67 / $100.00
| Facility | | $12.69 | $24.67 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.97 / $11.00 / $20.85
| Professional | | $5.97 | $11.00 | $20.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.36 / $24.76 / $35.36
| Facility | | $8.36 | $24.76 | $35.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $16.07 / $24.35
| Professional | | $8.44 | $16.07 | $24.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.60 / $11.66 / $12.82
| Professional | | $8.60 | $11.66 | $12.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $12.69 / $26.69
| Facility | | $12.09 | $12.69 | $26.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $18.13 / $33.25
| Facility | | $12.09 | $18.13 | $33.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.88 / $10.88 / $10.88
| Professional | | $10.88 | $10.88 | $10.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.90 / $19.95 / $33.25
| Facility | | $13.90 | $19.95 | $33.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $12.09 / $32.34
| Professional | | $9.07 | $12.09 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $13.54
| Professional | | $5.08 | $5.08 | $13.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $5.44 / $6.26
| Professional | | $5.44 | $5.44 | $6.26 |