- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.28 / $47.55 / $127.76
| Facility | | $11.28 | $47.55 | $127.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.11 / $10.27 / $15.48
| Professional | | $9.11 | $10.27 | $15.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $7.06 / $8.18
| Professional | | $7.06 | $7.06 | $8.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.36 / $22.95 / $60.00
| Facility | | $12.36 | $22.95 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.82 / $10.59 / $20.30
| Professional | | $5.82 | $10.59 | $20.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.15 / $19.43 / $34.43
| Facility | | $8.15 | $19.43 | $34.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $15.09 / $23.37
| Professional | | $8.26 | $15.09 | $23.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.38 / $11.35 / $12.48
| Professional | | $8.38 | $11.35 | $12.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.77 / $12.36 / $32.79
| Facility | | $11.77 | $12.36 | $32.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.77 / $17.66 / $32.36
| Facility | | $11.77 | $17.66 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.59 / $10.59 / $10.59
| Professional | | $10.59 | $10.59 | $10.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.54 / $19.42 / $32.36
| Facility | | $13.54 | $19.42 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $11.77 / $31.44
| Professional | | $8.83 | $11.77 | $31.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $5.83 / $13.18
| Professional | | $4.94 | $5.83 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.30 / $5.30 / $6.10
| Professional | | $5.30 | $5.30 | $6.10 |