- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.64 / $66.12 / $174.24
| Facility | | $11.64 | $66.12 | $174.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $20.94 / $42.84
| Professional | | $10.32 | $20.94 | $42.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $7.20 / $7.20
| Professional | | $7.20 | $7.20 | $7.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.60 / $24.00 / $88.55
| Facility | | $12.60 | $24.00 | $88.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $10.92 / $21.00
| Professional | | $5.92 | $10.92 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $24.57 / $127.11
| Facility | | $8.32 | $24.57 | $127.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $15.63 / $23.86
| Professional | | $8.26 | $15.63 | $23.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.54 / $11.58 / $12.73
| Professional | | $8.54 | $11.58 | $12.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $12.60 / $26.49
| Facility | | $12.00 | $12.60 | $26.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $18.00 / $33.00
| Facility | | $12.00 | $18.00 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $10.80 / $10.80
| Professional | | $10.80 | $10.80 | $10.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $19.80 / $33.00
| Facility | | $13.80 | $19.80 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $12.00 / $32.34
| Professional | | $9.00 | $12.00 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $5.40 / $12.00
| Professional | | $5.04 | $5.40 | $12.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.40 / $5.40 / $6.22
| Professional | | $5.40 | $5.40 | $6.22 |