- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $7.24
| Facility | | $5.08 | $5.08 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $8.03 / $9.80
| Professional | | $5.48 | $8.03 | $9.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.36 / $7.49 / $7.49
| Professional | | $6.36 | $7.49 | $7.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.62 / $82.65 / $82.65
| Facility | | $7.62 | $82.65 | $82.65 |
- 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
- $16.44 / $75.00 / $85.00
| Facility | | $16.44 | $75.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.28 / $55.28 / $70.34
| Professional | | $55.28 | $55.28 | $70.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.69 / $9.06 / $16.82
| Facility | | $6.69 | $9.06 | $16.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $12.19 / $15.64
| Professional | | $9.86 | $12.19 | $15.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.66 / $9.28 / $16.05
| Professional | | $7.66 | $9.28 | $16.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.69 / $9.06 / $19.64
| Facility | | $6.69 | $9.06 | $19.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $7.74 / $20.14
| Professional | | $7.74 | $7.74 | $20.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $9.84 / $15.61
| Professional | | $7.35 | $9.84 | $15.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.18 / $8.44 / $11.56
| Professional | | $7.18 | $8.44 | $11.56 |