- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.85 / $33.94 / $172.72
| Facility | | $8.85 | $33.94 | $172.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $15.00 / $54.26
| Professional | | $6.96 | $15.00 | $54.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.20 / $7.57 / $10.02
| Facility | | $6.20 | $7.57 | $10.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.89 / $6.96 / $16.47
| Professional | | $6.89 | $6.96 | $16.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.21 / $8.91 / $14.49
| Facility | | $8.21 | $8.91 | $14.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.09 / $7.09 / $20.16
| Professional | | $7.09 | $7.09 | $20.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $6.56 / $6.96
| Facility | | $6.56 | $6.56 | $6.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $6.96 / $6.96
| Professional | | $6.96 | $6.96 | $6.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.26 / $8.35 / $15.77
| Professional | | $6.26 | $8.35 | $15.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $12.68 / $23.68
| Professional | | $10.57 | $12.68 | $23.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $6.96 / $9.94
| Facility | | $6.56 | $6.96 | $9.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $6.96 / $15.05
| Professional | | $6.96 | $6.96 | $15.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $11.66
| Professional | | $11.66 | $11.66 | $11.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $7.65 / $11.83
| Professional | | $5.56 | $7.65 | $11.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $6.96 / $15.47
| Professional | | $6.96 | $6.96 | $15.47 |