- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.82 / $11.82 / $26.36
| Facility | | $11.82 | $11.82 | $26.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $11.82 / $12.33
| Professional | | $10.48 | $11.82 | $12.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.54 / $18.28 / $39.68
| Professional | | $11.54 | $18.28 | $39.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $22.34 / $31.93
| Facility | | $8.94 | $22.34 | $31.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.38 / $18.89 / $21.46
| Professional | | $9.38 | $18.89 | $21.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $12.62 / $24.23
| Facility | | $10.48 | $12.62 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.75 / $7.75 / $7.75
| Professional | | $7.75 | $7.75 | $7.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $12.62 / $24.23
| Facility | | $10.48 | $12.62 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.40 / $15.40 / $20.02
| Professional | | $15.40 | $15.40 | $20.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.33 / $55.00 / $85.00
| Professional | | $40.33 | $55.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $12.62 / $24.23
| Facility | | $10.48 | $12.62 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.75 / $7.75 / $7.75
| Professional | | $7.75 | $7.75 | $7.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.36 / $26.22 / $36.78
| Professional | | $18.36 | $26.22 | $36.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $8.94 / $8.94
| Professional | | $8.94 | $8.94 | $8.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.43 / $20.43 / $37.36
| Professional | | $20.43 | $20.43 | $37.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.40 / $15.40 / $21.56
| Professional | | $15.40 | $15.40 | $21.56 |