- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $20.60 / $24.52
| Facility | | $10.30 | $20.60 | $24.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.40 / $24.52
| Professional | | $10.30 | $10.40 | $24.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.56 / $16.45 / $36.88
| Facility | | $10.56 | $16.45 | $36.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $29.52
| Professional | | $10.30 | $10.30 | $29.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.71 / $12.35 / $23.69
| Facility | | $10.71 | $12.35 | $23.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $10.49 / $27.10
| Professional | | $10.49 | $10.49 | $27.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.72 / $9.72 / $10.30
| Facility | | $9.72 | $9.72 | $10.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $10.30
| Professional | | $10.30 | $10.30 | $10.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $12.36 / $23.34
| Professional | | $9.27 | $12.36 | $23.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.72 / $10.30 / $14.73
| Facility | | $9.72 | $10.30 | $14.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $22.28
| Professional | | $10.30 | $10.30 | $22.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.64 / $16.64 / $16.64
| Professional | | $16.64 | $16.64 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $11.33 / $17.51
| Professional | | $8.24 | $11.33 | $17.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $21.17
| Professional | | $10.30 | $10.30 | $21.17 |