- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $18.20 / $30.90
| Facility | | $8.13 | $18.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.03 / $28.84
| Professional | | $5.01 | $6.03 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $9.55 / $60.26
| Facility | | $6.17 | $9.55 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $8.13 / $16.98
| Professional | | $4.17 | $8.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $16.60 / $25.12
| Facility | | $13.18 | $16.60 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $7.59 / $8.13
| Professional | | $7.59 | $7.59 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $10.96 / $25.70
| Facility | | $5.62 | $10.96 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $10.00 / $12.30
| Professional | | $5.01 | $10.00 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $3,630.78 / $9,772.37
| Facility | | $7.76 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $13.80
| Professional | | $11.75 | $11.75 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $19.50
| Professional | | $8.13 | $8.13 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $14.79
| Facility | | $9.33 | $9.33 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $9.55 / $60.26
| Facility | | $6.17 | $9.55 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $8.13 / $16.98
| Professional | | $4.17 | $8.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $8.13 / $10.96
| Facility | | $4.07 | $8.13 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $5.37 / $16.22
| Professional | | $3.89 | $5.37 | $16.22 |