- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $16.07 / $94.42
| Facility | | $6.50 | $16.07 | $94.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.82 / $6.54 / $10.33
| Professional | | $4.82 | $6.54 | $10.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $4.13 / $4.13
| Professional | | $4.13 | $4.13 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $27.04 / $51.06
| Facility | | $8.94 | $27.04 | $51.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $5.00 / $7.52
| Professional | | $4.55 | $5.00 | $7.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $13.35 / $20.69
| Facility | | $8.61 | $13.35 | $20.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $8.61 / $8.61
| Facility | | $8.61 | $8.61 | $8.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.77 / $18.93 / $40.36
| Facility | | $6.77 | $18.93 | $40.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $6.62 / $14.77
| Professional | | $4.55 | $6.62 | $14.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.31 / $85.08 / $100.00
| Facility | | $80.31 | $85.08 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $8.61 / $11.19
| Facility | | $6.46 | $8.61 | $11.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.75 / $8.61 / $11.22
| Professional | | $7.75 | $8.61 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.72 / $8.61 / $23.79
| Facility | | $6.72 | $8.61 | $23.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $6.63 / $12.44
| Professional | | $4.55 | $6.63 | $12.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $7.04 / $8.61
| Professional | | $5.17 | $7.04 | $8.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $4.25 / $8.61
| Professional | | $3.36 | $4.25 | $8.61 |