- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $12.59 / $25.12
| Facility | | $10.00 | $12.59 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $13.49
| Professional | | $10.00 | $10.00 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $12.02
| Professional | | $10.47 | $10.47 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $10.00
| Facility | | $9.55 | $9.55 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $9.55
| Professional | | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.72 / $50,118.72
| Facility | | $10.00 | $10.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $43.65
| Professional | | $10.72 | $10.72 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $12.59 / $35.48
| Facility | | $9.77 | $12.59 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $13.18
| Professional | | $10.72 | $10.72 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $10.72
| Facility | | $10.23 | $10.23 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $10.72
| Professional | | $10.23 | $10.23 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $50,118.72 / $75,857.76
| Facility | | $13.18 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.47 / $15.14
| Professional | | $10.23 | $10.47 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $12.30
| Facility | | $10.23 | $10.23 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.72 / $12.30
| Professional | | $10.23 | $10.72 | $12.30 |