- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.09 / $18.23 / $21.45
| Facility | | $8.09 | $18.23 | $21.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.73 / $8.09 / $9.30
| Professional | | $6.73 | $8.09 | $9.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.46 / $9.02 / $11.71
| Facility | | $7.46 | $9.02 | $11.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $8.28 / $16.19
| Professional | | $2.57 | $8.28 | $16.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.28 / $8.28 / $14.04
| Facility | | $8.28 | $8.28 | $14.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $8.09 / $20.23
| Professional | | $8.09 | $8.09 | $20.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.28 / $8.28 / $8.28
| Facility | | $8.28 | $8.28 | $8.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.28 / $8.28 / $8.28
| Professional | | $8.28 | $8.28 | $8.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $12.00 / $393.93
| Professional | | $8.00 | $12.00 | $393.93 |
- 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
- $3.22 / $8.28 / $11.57
| Facility | | $3.22 | $8.28 | $11.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $5.34 / $8.28
| Professional | | $2.47 | $5.34 | $8.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.61 / $4.69 / $6.14
| Professional | | $3.61 | $4.69 | $6.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $16.59
| Professional | | $8.13 | $8.13 | $16.59 |