- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.85 / $24.58 / $102.22
| Facility | | $9.85 | $24.58 | $102.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.96 / $33.82
| Professional | | $9.86 | $9.96 | $33.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $62.13
| Professional | | $9.86 | $9.86 | $62.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.48 / $24.48 / $25.70
| Facility | | $24.48 | $24.48 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.48 / $24.48 / $24.48
| Professional | | $24.48 | $24.48 | $24.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.30 / $9.30 / $31.82
| Facility | | $9.30 | $9.30 | $31.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $9.86
| Professional | | $9.86 | $9.86 | $9.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.30 / $48.60 / $332.00
| Facility | | $9.30 | $48.60 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.70 / $10.70 / $25.85
| Professional | | $10.70 | $10.70 | $25.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $10.23
| Facility | | $9.86 | $9.86 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $10.23
| Professional | | $9.86 | $9.86 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.21 / $31.32 / $88.74
| Facility | | $10.21 | $31.32 | $88.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.30 / $9.30 / $555.00
| Facility | | $9.30 | $9.30 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $11.01 / $38.86
| Professional | | $9.86 | $11.01 | $38.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $9.86 / $17.77
| Professional | | $9.86 | $9.86 | $17.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $10.23
| Facility | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.86 / $10.23 / $31.50
| Professional | | $9.86 | $10.23 | $31.50 |