- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.53 / $5.53 / $284.77
| Facility | | $5.53 | $5.53 | $284.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.72 / $5.82 / $16.72
| Professional | | $4.72 | $5.82 | $16.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.95 / $9.86 / $29.84
| Professional | | $4.95 | $9.86 | $29.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $16.85 / $25.85
| Facility | | $14.42 | $16.85 | $25.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $15.73 / $19.12
| Professional | | $10.09 | $15.73 | $19.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.80 / $7.09 / $60.06
| Facility | | $4.80 | $7.09 | $60.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $7.39 / $135.25
| Facility | | $4.75 | $7.39 | $135.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $11.43 / $426.01
| Professional | | $5.05 | $11.43 | $426.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $58.40 / $85.00
| Professional | | $8.86 | $58.40 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $7.09 / $60.06
| Facility | | $4.75 | $7.09 | $60.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $16.07 / $84.77
| Professional | | $10.19 | $16.07 | $84.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $59.88 / $226.00
| Facility | | $7.24 | $59.88 | $226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.45 / $90.70 / $426.01
| Professional | | $23.45 | $90.70 | $426.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.94 / $15.94 / $15.94
| Professional | | $15.94 | $15.94 | $15.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.79 / $24.68 / $37.22
| Professional | | $16.79 | $24.68 | $37.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $10.34 / $20.89
| Professional | | $5.05 | $10.34 | $20.89 |