- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.36 / $23.27 / $79.31
| Facility | | $11.36 | $23.27 | $79.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $11.36 / $21.74
| Professional | | $9.61 | $11.36 | $21.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.69 / $20.61 / $113.50
| Facility | | $12.69 | $20.61 | $113.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $23.84 / $424.00
| Professional | | $10.28 | $23.84 | $424.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.99 / $24.76 / $35.36
| Facility | | $6.99 | $24.76 | $35.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.80 / $13.28 / $16.53
| Professional | | $6.80 | $13.28 | $16.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $17.77 / $34.11
| Facility | | $12.09 | $17.77 | $34.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.09 / $20.36 / $33.43
| Professional | | $12.09 | $20.36 | $33.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $75.00 / $75.00
| Professional | | $75.00 | $75.00 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $12.09 / $25.39
| Facility | | $12.09 | $12.09 | $25.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $21.16 / $36.27
| Facility | | $12.09 | $21.16 | $36.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.88 / $10.88 / $10.88
| Professional | | $10.88 | $10.88 | $10.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.69 / $19.84 / $33.25
| Facility | | $12.69 | $19.84 | $33.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.37 / $23.42 / $27.86
| Professional | | $13.37 | $23.42 | $27.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $8.42 / $25.16
| Professional | | $7.25 | $8.42 | $25.16 |