- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.60 / $15.60 / $676.10
| Facility | | $15.60 | $15.60 | $676.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $8.16 / $15.60
| Professional | | $6.76 | $8.16 | $15.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $14.06 / $47.65
| Professional | | $8.32 | $14.06 | $47.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.73 / $24.22 / $37.15
| Facility | | $20.73 | $24.22 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.14 / $10.95 / $26.34
| Professional | | $7.14 | $10.95 | $26.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.65 / $10.10 / $23.66
| Facility | | $7.65 | $10.10 | $23.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.51 / $10.77 / $24.53
| Facility | | $7.51 | $10.77 | $24.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.90 / $14.98 / $75.73
| Professional | | $8.90 | $14.98 | $75.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.14 / $58.40 / $85.00
| Professional | | $24.14 | $58.40 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.51 / $9.69 / $23.40
| Facility | | $7.51 | $9.69 | $23.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $19.01 / $27.25
| Professional | | $12.17 | $19.01 | $27.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $15.14 / $80.00
| Facility | | $9.69 | $15.14 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.14 / $41.55 / $75.73
| Professional | | $7.14 | $41.55 | $75.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.79 / $23.82 / $23.82
| Professional | | $12.79 | $23.82 | $23.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.90 / $14.50 / $29.09
| Professional | | $8.90 | $14.50 | $29.09 |