- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.88 / $10.23 / $11.61
| Facility | | $7.88 | $10.23 | $11.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.88 / $10.37 / $13.84
| Professional | | $7.88 | $10.37 | $13.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.94 / $18.11 / $44.08
| Facility | | $11.94 | $18.11 | $44.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.51 / $7.51 / $8.43
| Professional | | $7.51 | $7.51 | $8.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.75 / $11.84 / $15.78
| Professional | | $9.75 | $11.84 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.78 / $15.78 / $15.78
| Facility | | $15.78 | $15.78 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.98 / $9.49 / $9.49
| Facility | | $5.98 | $9.49 | $9.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $9.49
| Professional | | $8.07 | $8.07 | $9.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.58 / $78.58 / $118.50
| Professional | | $78.58 | $78.58 | $118.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.32 / $11.84 / $15.79
| Facility | | $4.32 | $11.84 | $15.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $14.20 / $15.78
| Professional | | $9.66 | $14.20 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.32 / $11.29 / $15.78
| Facility | | $4.32 | $11.29 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $13.12
| Professional | | $8.07 | $8.07 | $13.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.59 / $7.28 / $9.61
| Professional | | $5.59 | $7.28 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.91 / $7.91 / $15.78
| Professional | | $7.91 | $7.91 | $15.78 |