- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.98 / $15.00 / $155.78
| Facility | | $12.98 | $15.00 | $155.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $12.94 / $17.00
| Professional | | $9.28 | $12.94 | $17.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $11.93 / $14.23
| Professional | | $9.61 | $11.93 | $14.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $11.90 / $17.73
| Professional | | $9.24 | $11.90 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $15.19 / $25.00
| Professional | | $10.02 | $15.19 | $25.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $14.58
| Facility | | $10.00 | $10.00 | $14.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $11.30 / $18.88
| Professional | | $3.20 | $11.30 | $18.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.52 / $61.23 / $61.23
| Facility | | $57.52 | $61.23 | $61.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.88 / $91.77 / $117.60
| Professional | | $80.88 | $91.77 | $117.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.59 / $15.24 / $20.00
| Facility | | $11.59 | $15.24 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.71 / $15.95 / $24.90
| Professional | | $9.71 | $15.95 | $24.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.57 / $15.40 / $20.48
| Professional | | $11.57 | $15.40 | $20.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.93 / $15.32 / $20.00
| Facility | | $11.93 | $15.32 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $12.00 / $20.17
| Professional | | $3.20 | $12.00 | $20.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $13.26 / $21.40
| Professional | | $5.09 | $13.26 | $21.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $14.31 / $19.64
| Professional | | $12.14 | $14.31 | $19.64 |