- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $12.02 / $79.43
| Professional | | $7.08 | $12.02 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.35
| Facility | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $17.78 / $48.98
| Professional | | $9.12 | $17.78 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $39.81
| Facility | | $28.84 | $28.84 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $12.88 / $79.43
| Professional | | $10.96 | $12.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $19.50
| Facility | | $14.45 | $14.45 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $14.45 / $26.30
| Professional | | $12.30 | $14.45 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $20.89
| Professional | | $17.38 | $17.38 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $17.38 / $29.51
| Professional | | $14.79 | $17.38 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $104.71 / $104.71
| Facility | | $100.00 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $14.45 / $24.55
| Facility | | $6.61 | $14.45 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $14.45 / $16.98
| Professional | | $12.30 | $14.45 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Professional | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.68 / $6.03 / $13.49
| Facility | | $0.68 | $6.03 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $10.72 / $21.38
| Professional | | $7.76 | $10.72 | $21.38 |