- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $50.50 / $110.70
| Facility | | $12.41 | $50.50 | $110.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.28 / $11.65 / $20.48
| Professional | | $8.28 | $11.65 | $20.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $11.01 / $23.96
| Professional | | $7.77 | $11.01 | $23.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.60 / $25.90 / $70.00
| Facility | | $13.60 | $25.90 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.39 / $11.78 / $22.35
| Professional | | $6.39 | $11.78 | $22.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $26.52 / $37.89
| Facility | | $8.94 | $26.52 | $37.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $16.85 / $25.81
| Professional | | $8.94 | $16.85 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $12.49 / $13.73
| Professional | | $9.22 | $12.49 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.95 / $13.60 / $85.09
| Facility | | $12.95 | $13.60 | $85.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.95 / $19.42 / $35.61
| Facility | | $12.95 | $19.42 | $35.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $11.66
| Professional | | $11.66 | $11.66 | $11.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $21.37 / $35.61
| Facility | | $14.89 | $21.37 | $35.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.71 / $12.95 / $35.03
| Professional | | $9.71 | $12.95 | $35.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $5.44 / $14.50
| Professional | | $5.44 | $5.44 | $14.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.83 / $5.83 / $6.71
| Professional | | $5.83 | $5.83 | $6.71 |