- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.16 / $50.63 / $114.88
| Facility | | $11.16 | $50.63 | $114.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $10.31 / $20.62
| Professional | | $9.66 | $10.31 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $7.21 / $19.60
| Professional | | $6.92 | $7.21 | $19.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $20.18 / $60.00
| Facility | | $12.11 | $20.18 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.61 / $10.59 / $18.00
| Professional | | $4.61 | $10.59 | $18.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.13 / $18.57 / $29.07
| Facility | | $6.13 | $18.57 | $29.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.83 / $13.22 / $16.52
| Professional | | $11.83 | $13.22 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.20 / $11.12 / $12.23
| Professional | | $8.20 | $11.12 | $12.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.53 / $11.53 / $17.30
| Facility | | $11.53 | $11.53 | $17.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.53 / $17.29 / $31.71
| Facility | | $11.53 | $17.29 | $31.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.80 / $12.11 / $16.37
| Professional | | $9.80 | $12.11 | $16.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.26 / $18.92 / $31.71
| Facility | | $13.26 | $18.92 | $31.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $11.53 / $31.44
| Professional | | $8.65 | $11.53 | $31.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $4.84 / $11.53
| Professional | | $4.84 | $4.84 | $11.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.19 / $5.19 / $5.97
| Professional | | $5.19 | $5.19 | $5.97 |