- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $6.31 / $10.77
| Facility | | $4.47 | $6.31 | $10.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $6.31 / $9.73
| Professional | | $4.47 | $6.31 | $9.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $4.97 / $14.68
| Professional | | $4.55 | $4.97 | $14.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.97 / $8.57 / $8.57
| Facility | | $7.97 | $8.57 | $8.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.57 / $8.57 / $8.57
| Professional | | $8.57 | $8.57 | $8.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $12.05
| Facility | | $12.05 | $12.05 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $5.25
| Professional | | $5.25 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $18.80 / $332.00
| Facility | | $10.28 | $18.80 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.94 / $13.88 / $22.31
| Professional | | $5.94 | $13.88 | $22.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.56 / $5.56 / $5.94
| Facility | | $5.56 | $5.56 | $5.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $5.94 / $6.31
| Professional | | $5.56 | $5.94 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $597.00
| Facility | | $12.05 | $12.05 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $17.61
| Professional | | $5.25 | $5.25 | $17.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $6.17 / $12.96
| Professional | | $3.42 | $6.17 | $12.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.94 / $5.94 / $6.25
| Facility | | $5.94 | $5.94 | $6.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $5.94 / $6.31
| Professional | | $5.56 | $5.94 | $6.31 |