- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.06 / $12.13 / $30.83
| Facility | | $8.06 | $12.13 | $30.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $7.67 / $11.35
| Professional | | $6.05 | $7.67 | $11.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.27 / $7.79 / $16.07
| Professional | | $6.27 | $7.79 | $16.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $9.77
| Facility | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $9.77
| Professional | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.75 / $7.75 / $35.82
| Facility | | $7.75 | $7.75 | $35.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $11.07 / $25.80
| Professional | | $6.77 | $11.07 | $25.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $12.48 / $319.00
| Facility | | $6.92 | $12.48 | $319.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.53 / $7.71 / $18.05
| Professional | | $6.53 | $7.71 | $18.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.32 / $6.32 / $6.32
| Facility | | $6.32 | $6.32 | $6.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.86 / $8.46 / $14.33
| Professional | | $5.86 | $8.46 | $14.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.75 / $35.82 / $597.00
| Facility | | $7.75 | $35.82 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $10.80 / $21.93
| Professional | | $7.15 | $10.80 | $21.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.46 / $16.67
| Professional | | $6.33 | $8.46 | $16.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.35 / $9.35 / $30.63
| Facility | | $9.35 | $9.35 | $30.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.32 / $9.35 / $17.27
| Professional | | $6.32 | $9.35 | $17.27 |