- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $8.91 / $30.20
| Professional | | $7.94 | $8.91 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $18.62
| Professional | | $18.62 | $18.62 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $11.22 / $17.78
| Professional | | $10.47 | $11.22 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.72 / $19.05
| Professional | | $7.08 | $10.72 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $16.60 / $24.55
| Professional | | $11.75 | $16.60 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $9.33
| Facility | | $8.91 | $8.91 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $11.75 / $22.39
| Professional | | $8.91 | $11.75 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.78 / $22.91
| Professional | | $9.77 | $17.78 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.00 / $28.84
| Professional | | $7.94 | $10.00 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $8.71 / $11.75
| Professional | | $7.59 | $8.71 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $8.71 / $13.18
| Professional | | $7.41 | $8.71 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $9.55 / $13.18
| Professional | | $6.46 | $9.55 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $100.00 / $125.89
| Facility | | $67.61 | $100.00 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $10.00 / $17.78
| Professional | | $7.59 | $10.00 | $17.78 |