- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $6.17 / $11.94
| Facility | | $5.50 | $6.17 | $11.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.45 / $6.17 / $11.94
| Professional | | $3.45 | $6.17 | $11.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.28 / $16.66
| Professional | | $6.33 | $8.28 | $16.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $10.52 / $10.52
| Facility | | $9.77 | $10.52 | $10.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.52 / $10.52 / $10.52
| Professional | | $10.52 | $10.52 | $10.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $7.59 / $8.03
| Facility | | $7.59 | $7.59 | $8.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $6.45 / $8.93
| Professional | | $6.45 | $6.45 | $8.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.63 / $28.42 / $332.00
| Facility | | $12.63 | $28.42 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.83 / $9.09 / $22.36
| Professional | | $6.83 | $9.09 | $22.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.57 / $9.57 / $9.57
| Facility | | $9.57 | $9.57 | $9.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.13 / $9.13 / $10.52
| Professional | | $9.13 | $9.13 | $10.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $8.09 / $8.09
| Professional | | $8.09 | $8.09 | $8.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $7.59 / $555.00
| Facility | | $7.59 | $7.59 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $7.74 / $18.28
| Professional | | $6.45 | $7.74 | $18.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $6.30 / $10.74
| Professional | | $4.20 | $6.30 | $10.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.03 / $9.13 / $9.13
| Facility | | $9.03 | $9.13 | $9.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.13 / $9.13 / $9.57
| Professional | | $9.13 | $9.13 | $9.57 |