- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.06 / $14.29 / $15.47
| Facility | | $14.06 | $14.29 | $15.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $15.07 / $20.05
| Professional | | $13.18 | $15.07 | $20.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $18.01 / $18.01
| Professional | | $16.27 | $18.01 | $18.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.54 / $22.35 / $43.06
| Professional | | $21.54 | $22.35 | $43.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.81 / $23.81 / $75.00
| Facility | | $23.81 | $23.81 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.49 / $25.79 / $49.45
| Professional | | $12.49 | $25.79 | $49.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.68 / $30.69 / $60.00
| Professional | | $20.68 | $30.69 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $18.01 / $21.39
| Professional | | $16.27 | $18.01 | $21.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.06 / $14.29 / $15.47
| Facility | | $14.06 | $14.29 | $15.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $15.47 / $21.12
| Professional | | $13.45 | $15.47 | $21.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.00 / $44.00 / $44.00
| Professional | | $44.00 | $44.00 | $44.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.81 / $23.81 / $75.00
| Facility | | $23.81 | $23.81 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.19 / $25.79 / $52.04
| Professional | | $12.19 | $25.79 | $52.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.32 / $21.77 / $25.40
| Facility | | $21.32 | $21.77 | $25.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.26 / $21.77 / $24.16
| Professional | | $21.26 | $21.77 | $24.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.10 / $23.09 / $34.64
| Professional | | $19.10 | $23.09 | $34.64 |