- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.07 / $53.35 / $241.92
| Facility | | $10.07 | $53.35 | $241.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.95 / $10.19 / $20.92
| Professional | | $7.95 | $10.19 | $20.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.36 / $7.95 / $8.33
| Professional | | $6.36 | $7.95 | $8.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.36 / $43.33 / $78.56
| Facility | | $16.36 | $43.33 | $78.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.02 / $11.79
| Professional | | $5.00 | $7.02 | $11.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $20.54 / $71.81
| Facility | | $13.25 | $20.54 | $71.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.98 / $12.98 / $13.25
| Facility | | $12.98 | $12.98 | $13.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.26 / $26.60 / $60.83
| Facility | | $9.26 | $26.60 | $60.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.02 / $8.86 / $20.23
| Professional | | $7.02 | $8.86 | $20.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.42 / $70.00 / $70.00
| Facility | | $39.42 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.07 / $13.25 / $17.23
| Facility | | $10.07 | $13.25 | $17.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.93 / $13.25 / $15.62
| Professional | | $11.93 | $13.25 | $15.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.07 / $13.25 / $30.45
| Facility | | $10.07 | $13.25 | $30.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.02 / $9.32 / $17.32
| Professional | | $7.02 | $9.32 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $6.93 / $14.01
| Professional | | $5.57 | $6.93 | $14.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $5.92 / $13.25
| Professional | | $5.17 | $5.92 | $13.25 |