- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.48 / $8.02 / $9.47
| Facility | | $5.48 | $8.02 | $9.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $8.36 / $10.23
| Professional | | $5.48 | $8.36 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.97 / $8.66 / $16.82
| Professional | | $6.97 | $8.66 | $16.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $12.72 / $12.72
| Facility | | $12.72 | $12.72 | $12.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.72 / $12.72 / $12.72
| Professional | | $12.72 | $12.72 | $12.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.01 / $10.01 / $10.01
| Facility | | $10.01 | $10.01 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $7.74 / $7.74
| Professional | | $7.74 | $7.74 | $7.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $13.55 / $332.00
| Facility | | $4.00 | $13.55 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.53 / $11.90 / $17.82
| Professional | | $9.53 | $11.90 | $17.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.21 / $8.21 / $9.77
| Facility | | $8.21 | $8.21 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.18 / $9.60 / $17.72
| Professional | | $7.18 | $9.60 | $17.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.01 / $10.01 / $10.01
| Facility | | $10.01 | $10.01 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $9.36 / $19.87
| Professional | | $7.74 | $9.36 | $19.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.67 / $10.24 / $22.64
| Professional | | $7.67 | $10.24 | $22.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.21 / $9.48 / $9.77
| Facility | | $8.21 | $9.48 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $9.60 / $20.34
| Professional | | $7.77 | $9.60 | $20.34 |