- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.04 / $8.51 / $14.53
| Facility | | $6.04 | $8.51 | $14.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.04 / $8.51 / $13.12
| Professional | | $6.04 | $8.51 | $13.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.95 / $5.95 / $22.26
| Professional | | $5.95 | $5.95 | $22.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.75 / $11.56 / $11.56
| Facility | | $10.75 | $11.56 | $11.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.56 / $11.56 / $11.56
| Professional | | $11.56 | $11.56 | $11.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.26 / $16.26 / $16.26
| Facility | | $16.26 | $16.26 | $16.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.09 / $7.09 / $7.09
| Professional | | $7.09 | $7.09 | $7.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.88 / $25.40 / $332.00
| Facility | | $13.88 | $25.40 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.88 / $18.73 / $30.12
| Professional | | $13.88 | $18.73 | $30.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.46 / $7.46 / $8.02
| Facility | | $7.46 | $7.46 | $8.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.46 / $8.02 / $8.51
| Professional | | $7.46 | $8.02 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.26 / $16.26 / $597.00
| Facility | | $16.26 | $16.26 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.09 / $7.09 / $23.77
| Professional | | $7.09 | $7.09 | $23.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $8.33 / $17.48
| Professional | | $4.62 | $8.33 | $17.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $9.92
| Facility | | $8.02 | $8.02 | $9.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.46 / $8.02 / $8.51
| Professional | | $7.46 | $8.02 | $8.51 |