- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.68 / $17.43 / $18.20
| Facility | | $7.68 | $17.43 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.15 / $7.68 / $18.20
| Professional | | $4.15 | $7.68 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.50 / $9.50 / $9.50
| Professional | | $9.50 | $9.50 | $9.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.88 / $80.00 / $80.00
| Facility | | $11.88 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $11.88 / $99.38
| Professional | | $11.26 | $11.88 | $99.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.93 / $6.93 / $6.93
| Professional | | $6.93 | $6.93 | $6.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.03 / $18.27 / $26.90
| Facility | | $11.03 | $18.27 | $26.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $18.30 / $26.53
| Professional | | $11.03 | $18.30 | $26.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $11.42 / $11.42
| Professional | | $9.35 | $11.42 | $11.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $13.25 / $14.93
| Facility | | $10.76 | $13.25 | $14.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.85 / $13.57 / $14.93
| Professional | | $11.85 | $13.57 | $14.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $11.88 / $21.97
| Facility | | $11.26 | $11.88 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $13.25 / $15.24
| Professional | | $11.26 | $13.25 | $15.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.95 / $11.53 / $13.57
| Professional | | $10.95 | $11.53 | $13.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.47 / $6.92 / $10.97
| Professional | | $5.47 | $6.92 | $10.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $6.01 / $11.53
| Professional | | $6.01 | $6.01 | $11.53 |