- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.38 / $24.92 / $66.73
| Facility | | $11.38 | $24.92 | $66.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $11.38 / $23.61
| Professional | | $8.11 | $11.38 | $23.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $21.80 / $70.00
| Facility | | $12.72 | $21.80 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $24.64 / $90.83
| Professional | | $9.44 | $24.64 | $90.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $25.74 / $38.88
| Facility | | $12.59 | $25.74 | $38.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $12.81 / $18.34
| Professional | | $6.50 | $12.81 | $18.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $17.01 / $36.97
| Facility | | $12.11 | $17.01 | $36.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.11 / $17.01 / $34.75
| Professional | | $12.11 | $17.01 | $34.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.78 / $11.85 / $75.00
| Professional | | $10.78 | $11.85 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $12.11 / $26.73
| Facility | | $12.11 | $12.11 | $26.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.11 / $21.80 / $36.33
| Facility | | $12.11 | $21.80 | $36.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.90 / $10.90 / $10.90
| Professional | | $10.90 | $10.90 | $10.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $19.98 / $33.29
| Facility | | $12.72 | $19.98 | $33.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.49 / $22.65 / $28.39
| Professional | | $12.49 | $22.65 | $28.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $5.09 / $13.32
| Professional | | $5.09 | $5.09 | $13.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.45 / $5.45 / $5.98
| Professional | | $5.45 | $5.45 | $5.98 |