- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $14.79 / $20.42
| Facility | | $10.72 | $14.79 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $20.42
| Professional | | $7.08 | $7.08 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $10.72 / $16.60
| Facility | | $7.76 | $10.72 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.72 / $25.70
| Professional | | $10.23 | $10.72 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $12.59 / $16.98
| Facility | | $11.22 | $12.59 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $9.12 / $21.38
| Professional | | $7.08 | $9.12 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $7.08
| Facility | | $6.76 | $6.76 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $7.76 / $16.22
| Professional | | $6.46 | $7.76 | $16.22 |
- 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
- $7.24 / $7.24 / $7.24
| Professional | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $11.48 / $19.05
| Facility | | $6.61 | $11.48 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $12.88
| Professional | | $6.31 | $6.31 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $20.42 / $20.42
| Facility | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $19.05
| Professional | | $7.08 | $7.08 | $19.05 |