- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.91 / $30.48 / $55.55
| Facility | | $10.91 | $30.48 | $55.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.81 / $10.91 / $22.89
| Professional | | $10.81 | $10.91 | $22.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.53 / $36.47 / $90.00
| Facility | | $11.53 | $36.47 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $15.60 / $35.56
| Professional | | $9.36 | $15.60 | $35.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.12 / $35.22 / $61.58
| Facility | | $22.12 | $35.22 | $61.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.65 / $14.66 / $15.44
| Professional | | $14.65 | $14.66 | $15.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.90 / $19.05 / $40.99
| Facility | | $10.90 | $19.05 | $40.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.67 / $12.67 / $23.75
| Professional | | $8.67 | $12.67 | $23.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.40 / $22.40 / $26.35
| Professional | | $22.40 | $22.40 | $26.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.60 / $21.62 / $50.23
| Professional | | $15.60 | $21.62 | $50.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $12.77 / $12.77
| Facility | | $12.77 | $12.77 | $12.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $90.00 / $90.00
| Facility | | $36.72 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $9.36 / $24.18
| Professional | | $6.24 | $9.36 | $24.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $9.36 / $24.18
| Professional | | $6.55 | $9.36 | $24.18 |