- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.91 / $7.10 / $142.11
| Facility | | $5.91 | $7.10 | $142.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.51 / $7.75 / $10.23
| Professional | | $6.51 | $7.75 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.03 / $22.13 / $41.45
| Facility | | $9.03 | $22.13 | $41.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $8.90 / $12.93
| Professional | | $6.13 | $8.90 | $12.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.59 / $1.59 / $1.59
| Facility | | $1.59 | $1.59 | $1.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.88 / $10.89 / $18.07
| Professional | | $7.88 | $10.89 | $18.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.98 / $50.00 / $177.00
| Facility | | $17.98 | $50.00 | $177.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.33 / $179.00 / $179.00
| Professional | | $62.33 | $179.00 | $179.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.34 / $10.18 / $16.77
| Facility | | $7.34 | $10.18 | $16.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $10.42 / $14.51
| Professional | | $8.56 | $10.42 | $14.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.70 / $18.20 / $19.39
| Professional | | $14.70 | $18.20 | $19.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.34 / $10.09 / $16.82
| Facility | | $7.34 | $10.09 | $16.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.91 / $11.00 / $18.23
| Professional | | $7.91 | $11.00 | $18.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.58 / $8.64 / $13.72
| Professional | | $6.58 | $8.64 | $13.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.35 / $7.31 / $10.08
| Professional | | $6.35 | $7.31 | $10.08 |