- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $27.27 / $91.50
| Facility | | $9.77 | $27.27 | $91.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.89 / $15.84 / $21.88
| Professional | | $7.89 | $15.84 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.12 / $17.23 / $22.59
| Facility | | $14.12 | $17.23 | $22.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.78 / $15.69 / $34.51
| Professional | | $6.78 | $15.69 | $34.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $6.23 / $23.31
| Facility | | $5.01 | $6.23 | $23.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.99 / $15.99 / $39.97
| Professional | | $15.99 | $15.99 | $39.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $14.81 / $15.69
| Facility | | $14.81 | $14.81 | $15.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $15.69 / $15.69
| Professional | | $15.69 | $15.69 | $15.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.12 / $18.82 / $34.52
| Professional | | $14.12 | $18.82 | $34.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $15.69 / $22.44
| Facility | | $14.81 | $15.69 | $22.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $15.69 / $33.94
| Professional | | $15.69 | $15.69 | $33.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.87 / $14.87 / $14.87
| Professional | | $14.87 | $14.87 | $14.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.56 / $17.26 / $26.68
| Professional | | $12.56 | $17.26 | $26.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $15.69 / $32.03
| Professional | | $15.69 | $15.69 | $32.03 |