- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.80 / $15.07 / $17.11
| Facility | | $8.80 | $15.07 | $17.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.39 / $15.28 / $23.08
| Professional | | $12.39 | $15.28 | $23.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $24.56 / $64.59
| Facility | | $14.86 | $24.56 | $64.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.19 / $12.43 / $12.43
| Professional | | $11.19 | $12.43 | $12.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.26 / $23.26 / $23.26
| Facility | | $23.26 | $23.26 | $23.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $16.44 / $16.44
| Facility | | $9.33 | $16.44 | $16.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.97 / $13.97 / $16.44
| Professional | | $13.97 | $13.97 | $16.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.07 / $126.07 / $126.07
| Facility | | $121.07 | $126.07 | $126.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.25 / $136.25 / $186.00
| Professional | | $136.25 | $136.25 | $186.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.49 / $17.47 / $24.47
| Facility | | $7.49 | $17.47 | $24.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $21.40 / $26.75
| Professional | | $9.24 | $21.40 | $26.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.30 / $16.30 / $16.30
| Professional | | $16.30 | $16.30 | $16.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.49 / $16.64 / $23.94
| Facility | | $7.49 | $16.64 | $23.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.97 / $13.97 / $20.37
| Professional | | $13.97 | $13.97 | $20.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $12.62 / $16.64
| Professional | | $9.67 | $12.62 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $23.26
| Professional | | $11.75 | $11.75 | $23.26 |