- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $10.93 / $18.67
| Facility | | $7.76 | $10.93 | $18.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $10.93 / $16.86
| Professional | | $7.76 | $10.93 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $28.45
| Professional | | $6.50 | $6.50 | $28.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.81 / $14.85 / $14.85
| Facility | | $13.81 | $14.85 | $14.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.85 / $14.85 / $14.85
| Professional | | $14.85 | $14.85 | $14.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $7.28 / $7.28
| Professional | | $7.28 | $7.28 | $7.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.82 / $32.63 / $332.00
| Facility | | $17.82 | $32.63 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.72 / $24.14 / $38.69
| Professional | | $18.72 | $24.14 | $38.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $10.30
| Facility | | $10.30 | $10.30 | $10.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.95 / $14.85
| Professional | | $10.30 | $10.95 | $14.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $597.00
| Facility | | $20.89 | $20.89 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $7.28 / $30.53
| Professional | | $7.28 | $7.28 | $30.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.93 / $10.07 / $21.40
| Professional | | $5.93 | $10.07 | $21.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $12.75
| Facility | | $10.30 | $10.30 | $12.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $10.95
| Professional | | $10.30 | $10.30 | $10.95 |