- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $30.90 / $117.49
| Facility | | $12.02 | $30.90 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.72 / $36.31
| Professional | | $7.94 | $10.72 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.32 / $8.32
| Professional | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $12.59 / $21.88
| Facility | | $10.96 | $12.59 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $7.24 / $15.14
| Professional | | $5.89 | $7.24 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $9.12 / $13.80
| Facility | | $9.12 | $9.12 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $48.98
| Facility | | $7.76 | $7.76 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $7.76 / $16.98
| Professional | | $6.17 | $7.76 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $25.12 / $302.00
| Facility | | $7.94 | $25.12 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $7.76 / $16.60
| Professional | | $6.17 | $7.76 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $9.77 / $14.79
| Professional | | $6.61 | $9.77 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $12.59 / $27.54
| Professional | | $7.76 | $12.59 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $8.32 / $12.02
| Facility | | $4.27 | $8.32 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.24 / $14.45
| Professional | | $5.01 | $7.24 | $14.45 |