- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $14.53 / $39.60
| Facility | | $8.30 | $14.53 | $39.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.38 / $10.34 / $15.94
| Professional | | $8.38 | $10.34 | $15.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.59 / $10.34 / $10.34
| Professional | | $3.59 | $10.34 | $10.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.14 / $6.14 / $6.45
| Facility | | $6.14 | $6.14 | $6.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $6.14 / $6.14
| Professional | | $6.14 | $6.14 | $6.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.76 / $9.76 / $10.34
| Facility | | $9.76 | $9.76 | $10.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $10.34 / $10.34
| Professional | | $10.34 | $10.34 | $10.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.76 / $14.64 / $332.00
| Facility | | $9.76 | $14.64 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $16.80
| Professional | | $11.22 | $11.22 | $16.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.34 / $10.34 / $10.73
| Facility | | $10.34 | $10.34 | $10.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $10.34 / $10.73
| Professional | | $10.34 | $10.34 | $10.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.88 / $9.48 / $27.61
| Facility | | $4.88 | $9.48 | $27.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.76 / $9.76 / $555.00
| Facility | | $9.76 | $9.76 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $8.23 / $10.34
| Professional | | $1.00 | $8.23 | $10.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $10.34 / $15.86
| Professional | | $10.34 | $10.34 | $15.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $10.73
| Facility | | $10.73 | $10.73 | $10.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.43 / $10.34 / $10.73
| Professional | | $0.43 | $10.34 | $10.73 |