- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.88 / $7.72 / $14.95
| Facility | | $6.88 | $7.72 | $14.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.88 / $7.75 / $14.95
| Professional | | $6.88 | $7.75 | $14.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.91 / $7.91 / $23.33
| Professional | | $7.91 | $7.91 | $23.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.25 / $13.17 / $13.17
| Facility | | $12.25 | $13.17 | $13.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.17 / $13.17 / $13.17
| Professional | | $13.17 | $13.17 | $13.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.10 / $9.49 / $9.49
| Facility | | $8.10 | $9.49 | $9.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $11.17
| Professional | | $8.07 | $8.07 | $11.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.80 / $35.54 / $332.00
| Facility | | $15.80 | $35.54 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.16 / $11.85 / $28.91
| Professional | | $8.16 | $11.85 | $28.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.73
| Facility | | $2.73 | $2.73 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $11.41 / $11.41
| Professional | | $2.73 | $11.41 | $11.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.10 / $9.49 / $555.00
| Facility | | $8.10 | $9.49 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $9.49 / $22.97
| Professional | | $8.07 | $9.49 | $22.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.26 / $7.88 / $14.23
| Professional | | $5.26 | $7.88 | $14.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.30 / $11.41 / $11.41
| Facility | | $11.30 | $11.41 | $11.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $11.41 / $11.41
| Professional | | $2.73 | $11.41 | $11.41 |