- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.57 / $8.57 / $9.73
| Facility | | $8.57 | $8.57 | $9.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $9.36 / $12.18
| Professional | | $7.64 | $9.36 | $12.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $14.88 / $58.95
| Professional | | $8.51 | $14.88 | $58.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $46.92 / $55.78
| Facility | | $10.94 | $46.92 | $55.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $14.61 / $23.43
| Professional | | $9.30 | $14.61 | $23.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $12.23 / $26.69
| Professional | | $7.00 | $12.23 | $26.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.63 / $11.63 / $12.25
| Facility | | $11.63 | $11.63 | $12.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $11.63 / $17.34
| Professional | | $6.87 | $11.63 | $17.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.10 / $21.33 / $29.59
| Professional | | $10.10 | $21.33 | $29.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.77 / $20.72 / $20.72
| Facility | | $15.77 | $20.72 | $20.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.04 / $72.97 / $72.97
| Professional | | $12.04 | $72.97 | $72.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $13.30 / $63.68
| Professional | | $8.48 | $13.30 | $63.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $11.35 / $34.90
| Professional | | $8.11 | $11.35 | $34.90 |