- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.32 / $10.47 / $20.26
| Facility | | $9.32 | $10.47 | $20.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.32 / $11.09 / $20.26
| Professional | | $9.32 | $11.09 | $20.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $31.65
| Professional | | $10.73 | $10.73 | $31.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $17.85 / $17.85
| Facility | | $16.60 | $17.85 | $17.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.85 / $17.85 / $17.85
| Professional | | $17.85 | $17.85 | $17.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $15.15 / $15.15
| Facility | | $12.09 | $15.15 | $15.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $17.82
| Professional | | $12.88 | $12.88 | $17.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.42 / $48.20 / $332.00
| Facility | | $21.42 | $48.20 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.06 / $17.98 / $39.20
| Professional | | $11.06 | $17.98 | $39.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.38 / $13.16 / $17.85
| Professional | | $12.38 | $13.16 | $17.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $15.15 / $555.00
| Facility | | $12.09 | $15.15 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $14.22 / $31.92
| Professional | | $12.88 | $14.22 | $31.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.13 / $11.58 / $19.60
| Professional | | $7.13 | $11.58 | $19.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.38 / $12.38 / $15.33
| Facility | | $12.38 | $12.38 | $15.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.38 / $12.38 / $13.16
| Professional | | $12.38 | $12.38 | $13.16 |