- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.79 / $18.07 / $80.23
| Facility | | $10.79 | $18.07 | $80.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $14.57
| Professional | | $12.06 | $12.06 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $16.71
| Professional | | $12.06 | $12.06 | $16.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.89 / $13.89 / $14.58
| Facility | | $13.89 | $13.89 | $14.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.89 / $13.89 / $13.89
| Professional | | $13.89 | $13.89 | $13.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $11.37 / $12.05
| Facility | | $11.37 | $11.37 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $12.05
| Professional | | $12.05 | $12.05 | $12.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $17.05 / $332.00
| Facility | | $11.37 | $17.05 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.08 / $13.08 / $15.58
| Professional | | $13.08 | $13.08 | $15.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $12.51
| Facility | | $12.06 | $12.06 | $12.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $12.51
| Professional | | $12.06 | $12.06 | $12.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $13.25 / $15.98
| Facility | | $6.92 | $13.25 | $15.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $11.37 / $555.00
| Facility | | $11.37 | $11.37 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.55 / $12.05 / $17.11
| Professional | | $11.55 | $12.05 | $17.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $18.89
| Professional | | $12.06 | $12.06 | $18.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.51 / $12.51 / $12.51
| Facility | | $12.51 | $12.51 | $12.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $12.51
| Professional | | $12.06 | $12.06 | $12.51 |